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Sample records for carotid artery intima-media

  1. Cigarette smoking in military pilots and intima-media thickness of the carotid arteries

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    Jovelić Stojan

    2005-01-01

    Full Text Available Background. It is well known that smoking is associated with an increase in arterial wall thickness. However, most studies of this problem have been undertaken in age and sex heterogeneous groups, as well as in patients with already present other conventional risk factors. The aim of this study was to assess the effect of cigarette smoking on arterial wall thickness of the common carotid artery in asymptomatic pilots. Methods. The imaging of intima−media thickness of the posterior wall of the distal 1 cm of both common carotid arteries was performed using a B mode ultrasound device, in 39 pilots (37.05 ± 6.66 years, for whom smoking was the single cardiovascular risk factor. Comparisons were made with 49 non-smokers (35.12 ± 7.39 years. Results. The posterior walls of both common carotid arteries were thicker in smokers (left, p < 0.05; right, p > 0,05. Intima-media thickness was significantly lower on the right side than on the left side in both smokers and nonsmokers (p < 0.01. Conclusion. Cigarette smoking as the single cardiovascular risk factor was associated with the wall thickness of the carotid arteries in our study. This finding indicated that early atherosclerosis was already present in pilots - smokers entering middle age.

  2. Pre-clinical atherosclerosis evaluated by carotid artery intima-media thickness and the risk factors in children

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    YANG Xiao-zheng; LIU Ying; MI Jie; TANG Chao-shu; DU Jun-bao

    2007-01-01

    Background Atherosclerosis as a cardiovascular disease was found to begin even in the fetal period. However,information about risk factors of pre-clinical atherosclerosis in childhood has been limited. Hence, this study was aimed to find out the risk factors of atherosclerosis by measuring the carotid artery intima-media thickness in children. High resolution B-mode ultrasound used to examine the carotid artery intima-media thickness was demonstrated to be useful in finding the early carotid structural changes.Methods The study included 79 children who were divided into two groups according to their ages: group Ⅰ consisted of 42 children with ages from 5 to 9 years and group Ⅱ consisted of 37 children with ages from 10 to 18 years, Among them,23 had a positive family history for risk, such as hypertension, obesity or dyslipidemia. Blood samples were collected and total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein were assayed. The carotid artery intima-media thickness was measured by ultrasound. Comparisons were done between the two groups using Student's t tests and Chi-square analysis. Body mass index, blood pressure, levels of lipids, family history and the carotid artery intima-media thickness were calculated by conditional logistic regression analysis.Results Compared with the children without a positive family history, the incidence of the increased carotid artery intima-media thickness was significantly high (x2=4.364, P<0.05). There were no statistically significant differences between left and right carotid arteries in carotid artery intima-media thickness (P>0.05). In this study, diastolic blood pressure and the atherosclerosis index were suggested to be the risk factors to the thickened carotid artery intima-media thickness. In group I the diastolic blood pressure's odds radio was 1.187 (P=0.035) and the atherosclerosis index odds radio was 37.165 (P=0.001); in group Ⅱ the diastolic blood pressure's odds

  3. Carotid intima media thickness and arterial stiffness in children with acute rheumatic fever.

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    Çiftel, Murat; Yılmaz, Osman; Kardelen, Fırat; Kocabaş, Abdullah

    2014-01-01

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) constitute important public health problems in developing countries. Inflammation is present both in the early and late stages of the diseases. Chronic inflammation is known to be associated with atherosclerosis. We hypothesize that subclinical atherosclerosis and arterial stiffness may increase due to the ongoing inflammation as well as the increased pulse pressure and left-ventricular systolic dysfunction in RHD. The purpose of the present study was to investigate carotid intima media thickness (CIMT) and carotid artery stiffness in patients with ARF. Forty patients in follow-up due to ARF in the age group of 7-16 years (disease duration 1-10 years) and 36 volunteered subjects with similar body mass index were included in the study. The subjects included in the present study were compared regarding M-mode echocardiographic parameters and CIMT as well as carotid arterial strain (CAS), carotid artery distensibility (CAD), beta stiffness index (βSI), and pressure-strain elasticity modulus (Ep) as carotid artery stiffness parameters. CIMT (0.52 ± 0.08 and 0.48 ± 0.07 mm, p = 0.01), βSI (5.29 ± 2.98 and 3.02 ± 1.30, p < 0.001), and Ep (426.53 ± 210.50 and 254.44 ± 104.69 p < 0.001) were increased, whereas CAS (0.11 ± 0.01 and 0.19 ± 0.09, p < 0.001) and CAD (10.27 ± 4.69 and 17.76 ± 14.41, p < 0.001) were decreased in patients with ARF compared with the control group. There was a positive correlation between pulse pressure and βSI (r = 0.25, p = 0.02) and Ep (r = 0.28, p = 0.01) in addition to a correlation between left atrial dilatation and CIMT (r = 0.55 p < 0.001) in patients with ARF. CIMT and carotid artery stiffness were increased in patients with ARF. Patients with ARF may have an increased risk of subclinical atherosclerosis and cardiovascular events.

  4. Carotid, aorta and renal arteries intima-media thickness in patients with sporadic idiopathic hypoparathyroidism

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    Deshraj Meena

    2015-01-01

    Full Text Available Background: Alteration in homeostasis of calcium, phosphate and parathyroid hormone (PTH predispose to vascular calcification that increases the risk of cardiovascular morbidity and mortality. The data on this aspect are scarce in patients with sporadic idiopathic hypoparathyroidism (SIH. Objective: The aim was to assess the effect of altered calcium, phosphate and PTH homeostasis in patients with SIH on intima media thickness (IMT, a surrogate marker of increased vascular risk. Methods: In this case-control study, we measured carotid IMT (CIMT, aortic IMT (AIMT and renal arteries IMT (RIMT in 30 consecutive patients with SIH, and compared with healthy subjects. IMT was measured by ultrasound by a single operator blinded to subject′s details. Results: CIMT, AIMT, RIMT values in patients with SIH were significantly more than healthy subjects (0.60 ± 0.08 mm vs. 0.52 ± 0.09 mm, P = 0.001; 0.73 ± 0.09 mm vs. 0.65 ± 0.10, P = 0.004; and 0.34 ± 0.04 mm vs. 0.30 ± 0.05, P = 0.003, respectively. Clinical or biochemical parameters did not correlate with CIMT, AIMT and RIMT in patients with SIH. Conclusion: The vascular risk is increased in patients with SIH as assessed by CIMT, AIMT, and RIMT.

  5. Value of ultrasonic measurement of carotid intima-media thickness and arterial elasticity for assessment of coronary heart disease severity

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    Hou-Qiang Lin; Ping-An Qian

    2016-01-01

    Objective:To study the value of ultrasonic measurement of carotid intima-media thickness and arterial elasticity for assessment of coronary heart disease severity.Methods:Patients with coronary heart disease angina were selected as CHD group, healthy subjects were selected as control group, carotid artery ultrasonography was conducted to determine carotid intima-media thickness (IMT), and serum was collected to determine serum content of lipid metabolism indexes, adhesion molecules and chemokines.Results:Carotid IMT of CHD group was significantly higher than that of control group and the carotid IMT of patients with multi-vessel disease in CHD group was significantly higher than that of patients with single-vessel disease; LDL, ox-LDL, ApoB, PCSK9, RANTES, FKN, MCP-1, CCL21, CXCL16, ICAM-1, VCAM-1, LFA-1, P-selectin and E-selectin content in serum of patients with thickened carotid IMT and carotid plaque in CHD group were significantly higher than those of patients with normal carotid IMT, and LDL, ox-LDL, ApoB, PCSK9, RANTES, FKN, MCP-1, CCL21, CXCL16, ICAM-1, VCAM-1, LFA-1, P-selectin and E-selectin content in serum of patients with carotid IMT plaque in CHD group were significantly higher than those of patients with thickened carotid IMT.Conclusions: Ultrasonic measurement of carotid IMT and arterial elasticity can provide the basis for assessment of coronary heart disease severity, and the carotid IMT and arterial elasticity are closely related to the abnormal lipid metabolism as well as the changes in the content of adhesion molecules and chemokines.

  6. Factors associated with gender difference in the intima-media thickness of the common carotid artery

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    Tan, T.-Y.; Lu, C.-H.; Lin, T.-K.; Liou, C.-W. [Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Chuang, Y.-C., E-mail: tengyeowtan@yahoo.co [Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Schminke, U. [Department of Neurology, Ernst Moritz Arndt University, Greifswald (Germany)

    2009-11-15

    Aim: To investigate the gender differences associated with a thinner intima-media thickness (IMT) of the common carotid artery (CCA) in women. Materials and methods: In a sample of 218 consecutive healthy volunteers comprising 110 men and 108 women, the IMT of the CCA was measured using B-mode ultrasonography. Blood pressure, fasting blood sugar, body mass index (BMI), blood lipid profile, homocysteine, folic acid, uric acid, high sensitive C-reactive protein, and thiobarbituric acid reactive substances (TBARS) levels were measured and compared with each other in both genders. Results: The IMT of the CCA was significantly thinner in women than in men (p = 0.012). Blood pressure, fasting plasma glucose, BMI, low-density lipoprotein cholesterol, triglycerides, homocysteine, uric acid, and TBARS were significantly (p < 0.05) lower, folic acid and high-density lipoprotein cholesterol (HDL-C) were significantly (p < 0.0001) higher in women compared with men. Multivariable logistic regression analysis revealed that higher serum levels of homocysteine, uric acid, and TBARS, and lower serum levels of HDL-C were significantly (p < 0.05) associated with male sex. Multiple linear regression analysis further revealed that age, sex, and BMI were independently associated with CCA IMT. Conclusions: The IMT of the CCA was thinner in women than in men. Traditional vascular risk factors explain only a small amount of variance in multivariate regression models supporting the hypothesis that other behavioural, sex hormone-related or genetic factors, which have not been sufficiently explored so far, may play a role in the gender differences of IMT.

  7. The Short-Term Effect of Ketogenic Diet on Carotid Intima-Media Thickness and Elastic Properties of the Carotid Artery and the Aorta in Epileptic Children.

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    Doksöz, Önder; Güzel, Orkide; Yılmaz, Ünsal; İşgüder, Rana; Çeleğen, Kübra; Meşe, Timur; Uysal, Utku

    2015-10-01

    The aim of this prospective study is to investigate the effect of a 6-month-long ketogenic diet on carotid intima-media thickness, carotid artery, and aortic vascular functions. Thirty-eight drug-resistant epileptic patients who were being treated with ketogenic diet were enrolled. Fasting total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, total cholesterol, and glucose concentrations were measured and echocardiography was performed in all patients before the beginning of ketogenic diet and at the sixth month of treatment. The body weight, height, body mass index, serum levels of triglyceride, total cholesterol, and low-density lipoprotein increased significantly at month 6 when compared to baseline values (P ketogenic diet has no effect on carotid intima-media thickness and elastic properties of the carotid artery and the aorta.

  8. Association of carotid artery intima-media thickness with complex aortic atherosclerosis in patients with recent stroke.

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    Fasseas, Panayotis; Brilakis, Emmanouil S; Leybishkis, Biana; Cohen, Marc; Sokil, Alexis B; Wolf, Nelson; Dorn, Rose Lee; Roberts, Andrew; VanDecker, William

    2002-01-01

    This study was undertaken to determine whether carotid intima-media thickness can predict complex aortic atherosclerosis. A retrospective review was conducted of 64 consecutive patients who underwent transesophageal echocardiography and carotid ultrasonography for evaluation of recent ischemic stroke at MCP Hahnemann University, Medical College of Pennsylvania Hospital between January 1, 1999, and December 31, 1999. The mean age was 65+/-14 years and 59% of the patients were women. Thirty-nine patients (61%) had carotid atherosclerosis (defined as an intima-media thickness > or =1 mm) and seven patients (11%) had complex aortic atherosclerosis (defined as the presence of protruding atheroma > or =4 mm thick, mobile atherosclerotic debris, or plaque ulceration in any aortic segment by transesophageal echocardiography). Compared to patients without complex aortic atherosclerosis, patients with complex aortic atherosclerosis were more likely to have hypercholesterolemia (19% vs 57%, p = 0.05) and a carotid intima-media thickness of 2 mm or greater (35% vs 86%, p = 0.02). A carotid intima-media thickness of 2 mm or more had 86% sensitivity, 65% specificity, 23% positive predictive value, 97% negative predictive value, 2.5 positive likelihood ratio, and 0.22 negative likelihood ratio for the diagnosis of complex aortic atherosclerosis. Carotid intimamedia thickness measurement can be used to noninvasively estimate the probability of complex aortic atherosclerosis. A carotid intima-media thickness less than 2 mm makes complex aortic atherosclerosis very unlikely.

  9. Association between microalbuminuria and subclinical atherosclerosis evaluated by carotid artery intima-media in elderly patients with normal renal function

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    Kong XiangLei

    2012-06-01

    Full Text Available Abstract Background Moderate to severe renal insufficiency and albuminuria have been shown to be independent risk factors for atherosclerosis. However, little is known about the direct association between subclinical atherosclerosis evaluated by carotid artery intima-media thickness (IMT and microalbuminuria in elderly patients with normal renal function. Methods Subjects were 272 elderly patients (age  ≥ 60 years with normoalbuminuria (n = 238 and microalbuminuria (n = 34. Carotid IMT was measured by means of high-resolution B-mode ultrasonography. Estimated glomerular filtration rate (eGFR ≥ 60 ml/min/1.73 m2 was defined as normal renal function. Those who had macroalbuminuria and atherosclerotic vascular disease were not included. Results Compared to subjects with normoalbuminuria, subjects with microalbuminuria had higher mean carotid IMT (1.02 ± 0.38 vs. 0.85 ± 0.28 mm; P  Conclusions A slight elevation of albuminuria is a significant determinant of carotid IMT independent of traditional cardiovascular risk factors in our patients. Our study further confirms the importance of intensive examinations for the early detection of atherosclerosis when microalbuminuria is found in elderly patients, although with normal renal function.

  10. Intima-Media Thickness of Carotid Artery is Associated with Insulin Sensitivity and Glucose Tolerance in Elderly Chinese

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    Yi-na Zhang; Can Cui; Ying Fan; Man-li Chang; Wei Wu; Wei-gang Yu; Ning Tan; Feng-chen Liu; Jin-chao Zhang

    2005-01-01

    @@ Previous studies have shown that patients with type 2 diabetes and even those with impaired glucose tolerance (IGT)have marked higher risk of atherosclerosis than nondiabetic subjects. The relationship between carotid atherosclerosis intima-media thickness (IMT) with glucose tolerance status and insulin sensitivity was studied in the elderly Chinese subjects.

  11. Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

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    Ciccone Marco M

    2011-11-01

    Full Text Available Abstract Background Intima-media thickness of the common carotid artery (CCA-IMT is a validated marker of systemic atherosclerosis process. The aim of this study was to evaluate the association between coronary artery disease (CAD, left ventricular hypertrophy (LVH and CCA-IMT, assessed by Radio Frequency-Quality Intima Media Thickness (RFQIMT method, the next generation of IMT real-time measurement, based on the direct analysis of the radiofrequency signal and endowed with high accuracy and reproducibility in early detection of arterial wall thickness. Methods 115 patients (76 men, mean age: 65.1 ± 12 years referred to our department and shown significant (≥ 70% luminal obstruction stenosis at least in one major epicardial coronary artery were studied. Coronary angiograms were divided for severity and extent of the disease: 79 patients (69% had one, 24 patients (21% two, 12 patients (10% three major epicardial coronary arteries with ≥ 70% stenosis. All patients underwent echocardiography and carotid ultrasound examination, assessed by RF. Results Dividing RFQIMT data in tertiles, dyslipidaemia (31 patients with IMT ≥ 1.20 mm vs 16 with IMT = 0.91-1.19 vs 25 with IMT ≤ 0.9, p = 0.004, LVMI (153.5 ± 20.6 g/m2 in IMT ≥ 1.20 mm vs 131.2 ± 8.4 g/m2 in IMT = 0.91-1.19 mm vs 114.3 ± 11.1 g/m2 in IMT ≤ 0.9 mm, P 2 = 0.88, RFQIMT remained significantly associated with the dyslipidemia (regression coefficient ± standard error [SE]: 0.057 ± 0.023; p = 0.017, LVMI (regression coefficient ± SE: 0.01 ± 0.001; P Conclusions RFQIMT is a sophisticated method for carotid ultrasound evaluation. Its evaluation in patients with at least one important major epicardial coronary vessel stenosis would help the accuracy in the general assessment of the number of coronary lesions in these patients.

  12. Evaluation of Carotid Arterial Intima-Media Thickness (IMT and Its Relation to Clinical Parameters in Japanese Children

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    Tamura,Hiroko

    2011-02-01

    Full Text Available The aim of this study was to evaluate the carotid arterial intima-media thickness (IMT and its relation to clinical parameters in Japanese children. Fifty-two healthy children (39 boys and 13 girls, aged 6-14 years, were enrolled in this cross-sectional investigation study. IMT of the common carotid artery was determined using ultrasonography. We also investigated anthropometric parameters, blood pressure (BP, lifestyles and blood examinations. The mean value of IMT was 0.4±0.1mm, which was lower than the normal value (1.0mm in adults. IMT was positively correlated with age (r=0.340 and height (r=0.346 in boys, while it was positively correlated with body mass index (BMI (r=0.584 and diastolic BP (DBP (r=0.563 in girls. In addition, IMT was associated with sleeping hours and hours of watching television (TV by using stepwise regression analysis. In conclusion, IMT increased with aging, and it was linked to some clinical parameters of atherosclerosis and lifestyles in children. Therefore, this reference data will be helpful for future assessment of age-related change in Japanese children in clinical practice, and IMT might be a good predictor of atherosclerosis in Japanese children.

  13. Impaired brachial artery flow-mediated dilation and increased carotid intima-media thickness in rheumatoid arthritis patients

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    FAN Chun-yan; ZHANG Zhi-yi; MEI Yi-fang; WU Chang-jun; SHEN Bao-zhong

    2012-01-01

    Background Carotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation percentage (FMD%) are common parameters used for detecting subclinical atherosclerosis.This study compared subclinical atherosclerosis of the carotid and brachial arteries in rheumatoid arthritis (RA) patients and healthy controls using high resolution ultrasonography.We also investigated their correlation with clinical factors and the association between FMD% and CIMT.Methods One hundred and two RA patients and 46 age-gender matched healthy controls were included in the study.FMD of the brachial artery and CIMT were measured ultrasonographically.Patients with diabetes mellitus,hypertension,renal failure,history of cardiovascular or cerebrovascular disease were excluded.Subjects who were receiving or used high dose steroids were also excluded.Results The CIMT was significantly higher in patients than that in the control group ((0.697±0.053) vs.(0.554±0.051) mm,P <0.001),whereas brachial artery FMD% was lower in patients than that in the controls ((5.454±2.653)% vs.(8.477±2.851)%,P <0.001).CIMT was related to age,disease duration,tender and swollen joint score,C-reactive protein,systolic blood pressure and high-density lipoprotein.However,FMD% was only association with systolic blood pressure.There was no significant correlation between CIMT and FMD%.Conclusions Compared with the healthy control subjects,RA patients without clinically evident cardiovascular disease had subclinical atherosclerosis in terms of impaired FMD% and increased CIMT.FMD% and CIMT may measure a different stage of subclinical atherosclerosis in RA patients.

  14. Automatic detection of the intima-media thickness in ultrasound images of the common carotid artery using neural networks.

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    Menchón-Lara, Rosa-María; Bastida-Jumilla, María-Consuelo; Morales-Sánchez, Juan; Sancho-Gómez, José-Luis

    2014-02-01

    Atherosclerosis is the leading underlying pathologic process that results in cardiovascular diseases, which represents the main cause of death and disability in the world. The atherosclerotic process is a complex degenerative condition mainly affecting the medium- and large-size arteries, which begins in childhood and may remain unnoticed during decades. The intima-media thickness (IMT) of the common carotid artery (CCA) has emerged as one of the most powerful tool for the evaluation of preclinical atherosclerosis. IMT is measured by means of B-mode ultrasound images, which is a non-invasive and relatively low-cost technique. This paper proposes an effective image segmentation method for the IMT measurement in an automatic way. With this purpose, segmentation is posed as a pattern recognition problem, and a combination of artificial neural networks has been trained to solve this task. In particular, multi-layer perceptrons trained under the scaled conjugate gradient algorithm have been used. The suggested approach is tested on a set of 60 longitudinal ultrasound images of the CCA by comparing the automatic segmentation with four manual tracings. Moreover, the intra- and inter-observer errors have also been assessed. Despite of the simplicity of our approach, several quantitative statistical evaluations have shown its accuracy and robustness.

  15. Comparison of intima-media thickness of common and internal carotid arteries of patients with ischemic stroke and intracerebral hemorrhage.

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    Ali Moghtaderi

    2014-12-01

    Full Text Available Role of atherosclerosis in the pathogenesis of ischemic and hemorrhagic infarctions is still matter of debate. Intima-media thickness (IMT of the common carotid artery (CCA and internal carotid artery (ICA are markers of atherosclerosis. The aim of this study was to compare CCA IMT and ICA IMT of patients with ischemic and hemorrhagic infarction.Two equal groups of 80 patients with small and large vessel ischemic stroke and 80 patients with non-traumatic intracerebral hemorrhage (ICH who referred to our central teaching hospital of Zahedan were assessed in this descriptive study. IMT of four arteries (right and left CCA and ICA were measured, and collected data were analysis using Student's t-test.There were 137 males (57.1% and 103 (42.9% female with mean age of 62.7 ± 11.7. Mean right CCA IMT of patients with small vessel diseases (SVD, large vessel diseases (LVD, and ICH were 0.564 ± 0.130, 0.623 ± 0.150, and 0.580 ± 0.140 mm, respectively (P = 0.032. Mean left CCA IMT of patients with SVD, LVD, and ICH were 0.569 ± 0.120, 0.618 ± 0.120, and 0.573 ± 0.130 mm, respectively (P = 0.039. The above findings for right ICA were 0.572 ± 0.120, 0.569 ± 0.140, and 0.522 ± 0.130 mm, respectively (P = 0.145. Those findings for left ICA IMT were 0.525 ± 0.110, 0.554 ± 0.120, and 0.527 ± 0.120 mm, respectively (P = 0.257.Our findings showed that by using CCA IMT, differentiation between small and large vessel infarctions and hemorrhagic infarctions can be made.

  16. Relationship between leukoaraiosis, carotid intima-media thickness and intima-media thickness variability: Preliminary results

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    Lucatelli, Pierleone [University of Rome la Sapienza, Department of Radiology, Rome (Italy); Raz, Eytan [New York University Langone Medical Center, Department of Radiology, New York, NY (United States); Saba, Luca [Azienda Ospedaliero Universitaria, Department of Radiology, di Cagliari - Polo di Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliera Brotzu, Department of Radiology, Cagliari (Italy); Montisci, Roberto [Azienda Ospedaliero Universitaria, Department of Vascular Surgery, di Cagliari - Polo di Monserrato, Cagliari (Italy); Wintermark, Max [University of Virginia, Department of Radiology, Neuroradiology Division, 1215 Lee Street-New Hospital, PO Box 800170, Charlottesville, VA (United States); King, Kevin S. [University of Texas Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Molinari, Filippo [Politecnico di Torino, Biolab, Department of Electronics, Torino (Italy); Ikeda, Nobutaka [Toho University Ohashi Medical Center, Division of Cardiovascular Medicine, Tokyo (Japan); Suri, Jasjit S. [AtheroPoint trademark LLC, Diagnostic and Monitoring Division, Roseville, CA (United States); University of Idaho, Department of Electrical Engineering, Pocatello, ID (United States)

    2016-12-15

    To assess the relationship between the degree of leukoaraiosis (LA), carotid intima-media thickness (IMT) and intima-media thickness variability (IMTV). Sixty-one consecutive patients, who underwent a brain MRI examination and a carotid artery ultrasound, were included in this retrospective study, which conformed with the Declaration of Helsinki. Written informed consent was waived. In each patient, right/left carotid arteries and brain hemispheres were assessed using automated software for IMT, IMTV and LA volume. The mean hemispheric LA volume was 2,224 mm{sup 3} (SD 2,702 mm{sup 3}) and there was no statistically significant difference in LA volume between the right and left hemispheres (p value = 0.628). The mean IMT and IMTV values were 0.866 mm (SD 0.170) and 0.143 mm (SD 0.100), respectively, without significant differences between the right and left sides (p values 0.733 and 0.098, respectively). The correlation coefficient between IMTV and LA volume was 0.41 (p value = 0.0001), and 0.246 (p value = 0.074) between IMT and LA volume. IMTV significantly correlates with LA volume. Further studies are warranted to verify whether this parameter can be used clinically as a marker of cerebrovascular risk. (orig.)

  17. Brachial artery flow-mediated dilatation and carotid intima-media thickness in young ED patients with insulin resistance.

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    Chen, S-F; Yao, F-J; Sun, X-Z; Wu, R-P; Huang, Y-P; Zheng, F-F; Yang, Q-Y; Han, D-Y; Xie, M-Q; Ding, M; Zhang, Y; Liu, G-H; Deng, C-H

    2016-09-01

    The evidence of a close relationship between cardiovascular disease and erectile dysfunction (ED) is well documented. The aim of this study is to investigate whether there is an early asymptomatic impairment of the peripheral vasculature in young ED patients without obvious cardiovascular disease. We studied a total of 261 ED patients (19-40 years old) and 40 age-matched healthy controls. All participants received questionnaires of cardiovascular risk factors and erectile function assessment, were subjected to lab tests of fasting blood sample, and underwent the ultrasonographic examination of brachial artery flow-mediated dilation (FMD) and carotid intima-media thickness (c-IMT). Insulin resistance (IR) was measured by the homeostasis model assessment of insulin resistance (HOMA-IR). Compared with normal human controls, FMD was significantly lower, whereas the average c-IMT was significantly greater in ED patients. An inverse correlation was found between FMD and mean c-IMT. The ED patients had significantly higher levels of fasting glucose, fasting insulin and HOMA-IR index, but showed relatively lower total testosterone and prolactin levels than the controls. Both FMD and c-IMT showed a significant correlation with International Index of Erectile Function-5 questionnaire (IIEF-5) score, age and HOMA-IR. Multivariate stepwise regression analysis demonstrated that age, HOMA-IR and IIEF-5 score were the risk factors associated with FMD and c-IMT. In conclusion, young ED patients in association with IR display diminished FMD and increased c-IMT. Furthermore, ED, HOMA-IR and age are independent predictors of the two subclinical atherosclerotic markers.

  18. Assessment of intima-media complex in carotid, femoral and right subclavian arteries for early investigation of atherosclerosis in HIV-infected patients

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    Emmanuelle Tenorio Albuquerque Madruga Godoi

    2013-12-01

    Full Text Available Objective To compare automatic and manual measurements of intima-media complex (IMC in common carotid, common femoral and right subclavian arteries of HIV-infected patients in relation to a control group, taking into consideration the classical risk factors for atherosclerosis. Materials and Methods The study sample comprised 70 HIV-infected patients and 70 non-HIV-infected controls paired according sex and age. Automatic (gold standard and manual measurements of IMC were performed in the carotid arteries. Manual measurements were also performed in common femoral and right subclavian arteries. Bland-Altman graphs were utilized in the comparison and the adopted level significance was 5%. Results Intima-media complex alterations were not observed in any of the individuals as the mean automatic measurement in the right common carotid (RCC artery was considered as the gold standard. As the gold standard was compared with the manual measurements (mean, maximum and minimum, no clinically significant alteration was observed. As the gold standard was compared with other sites, the difference was statistically and clinically significant at the origin of right subclavian artery (RCC: 0.51 mm vs. 0.91 mm (p < 0.001. Conclusion HIV-infected individuals are not at higher risk for atherosclerosis than the control population.

  19. Association of branched-chain amino acids with carotid intima-media thickness and coronary artery disease risk factors.

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    Ruiyue Yang

    Full Text Available BACKGROUND: Recent studies have determined that branched-chain (BCAAs and aromatic (AAAs amino acids are strongly correlated with obesity and atherogenic dyslipidemia and are strong predictors of diabetes. However, it is not clear if these amino acids are capable of identifying subjects with coronary artery disease (CAD, particularly with subclinical atherosclerosis who are at risk of developing CAD. METHODS: Four hundred and seventy two Chinese subjects (272 males and 200 females, 42-97 y of age undergoing physical exams were recruited at random for participation in the cross-sectional study. Serum BCAAs and AAAs were measured using our previously reported isotope dilution liquid chromatography tandem mass spectrometry method. Bilateral B-mode carotid artery images for carotid intima-media thickness (cIMT were acquired at end diastole and cIMT values more than 0.9 mm were categorized as increased. Correlations of BCAAs with cIMT and other CAD risk factors were analyzed. RESULTS: BCAAs and AAAs were significantly and positively associated with risk factors of CAD, e.g., cIMT, BMI, waist circumference, blood pressure, fasting blood glucose, TG, apoB, apoB/apoAI ratio, apoCII, apoCIII and hsCRP, and were significantly and negatively associated with HDL-C and apoAI. Stepwise multiple linear regression analysis revealed that age (β = 0.175, P<0.001, log BCAA (β = 0.147, P<0.001 and systolic blood pressure (β = 0.141, P = 0.012 were positively and independently associated with cIMT. In the logistic regression model, the most and only powerful laboratory factor correlated with increased cIMT was BCAA (the odds ratio of the fourth quartile compared to the first quartile was 2.679; P = 0.009. CONCLUSION: BCAAs are independently correlated with increased cIMT. This correlation would open a new field of research in the mechanistic understanding and risk assessment of CAD.

  20. Association Between Macrominerals Intake and Changes in Internal Carotid Artery-Intima Media Thickness in POST Ischemic Stroke Patients

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    Pudjonarko, Dwi; Tugasworo, Dodik; Silaen, Rumintang

    2017-02-01

    Carotid Intima Media Thickness (C-IMT) has been widely used as marker for atherosclerosis. Previous studies on minerals intake and its association with C-IMT revealed various. Most of the studies showed inconsistent results. The aim of this study is to determine wether macro minerals intake is related to internal carotid-intima media thickness (IC-IMT). This is a longitudinal study, pre test post test design conducted in Neurology clinic, Kariadi hospital, Semarang from June to December 2014. Subjects were 22 post ischemic stroke patients. Minerals intake and IC-IMT was measured using Food Frequency Questionnaire and Duplex Carotid Ultrasonography. Statistical analysis was performed using Chi-Square, Fisher Exact and Logistic Regression test. Subjects included in this study were 17 male subjects (77.3%) and 5 female subjects (22.7%). Mean of IC-IMT in female subjects was found to be higher than in male. Mean of total IC-IMT was increased after a period of six months (0.96±0.80 to 0.97±0.21 mm). There were significant association between calcium as well as sodium intakes and IC-IMT. In contrast, there were no association between magnesium as well as potassium intake and IC-IMT. Multivariate analysis suggest that sodium intake (OR=26.828) was the most influencing factor for IC-IMT, followed by calcium intake (OR=0.042). Calcium as well as potassium intake were independently associated with IC-IMT. Magnecium as well as sodium intake were not independently associated with IC-IMT changes. Sodium intake was the most influencing variable to IC-IMT changes, followed by calcium intake.

  1. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation.

    Science.gov (United States)

    Aviram, Michael; Rosenblat, Mira; Gaitini, Diana; Nitecki, Samy; Hoffman, Aaron; Dornfeld, Leslie; Volkova, Nina; Presser, Dita; Attias, Judith; Liker, Harley; Hayek, Tony

    2004-06-01

    Dietary supplementation with polyphenolic antioxidants to animals was shown to be associated with inhibition of LDL oxidation and macrophage foam cell formation, and attenuation of atherosclerosis development. We investigated the effects of pomegranate juice (PJ, which contains potent tannins and anthocyanins) consumption by atherosclerotic patients with carotid artery stenosis (CAS) on the progression of carotid lesions and changes in oxidative stress and blood pressure. Ten patients were supplemented with PJ for 1 year and five of them continued for up to 3 years. Blood samples were collected before treatment and during PJ consumption. In the control group that did not consume PJ, common carotid intima-media thickness (IMT) increased by 9% during 1 year, whereas, PJ consumption resulted in a significant IMT reduction, by up to 30%, after 1 year. The patients' serum paraoxonase 1 (PON 1) activity was increased by 83%, whereas serum LDL basal oxidative state and LDL susceptibility to copper ion-induced oxidation were both significantly reduced, by 90% and 59%, respectively, after 12 months of PJ consumption, compared to values obtained before PJ consumption. Furthermore, serum levels of antibodies against oxidized LDL were decreased by 19%, and in parallel serum total antioxidant status (TAS) was increased by 130% after 1 year of PJ consumption. Systolic blood pressure was reduced after 1 year of PJ consumption by 12% [corrected] and was not further reduced along 3 years of PJ consumption. For all studied parameters, the maximal effects were observed after 1 year of PJ consumption. Further consumption of PJ, for up to 3 years, had no additional beneficial effects on IMT and serum PON1 activity, whereas serum lipid peroxidation was further reduced by up to 16% after 3 years of PJ consumption. The results of the present study thus suggest that PJ consumption by patients with CAS decreases carotid IMT and systolic blood pressure and these effects could be related to

  2. Carotid plaque, intima-media thickness, and incident aortic stenosis

    DEFF Research Database (Denmark)

    Martinsson, Andreas; Östling, Gerd; Persson, Margaretha

    2014-01-01

    OBJECTIVE: Aortic stenosis (AS) shares risk factors with atherosclerotic vascular disease. Carotid intima-media thickness (IMT) and plaque may reflect the cumulative damage from exposure to different atherosclerotic risk factors. We examined the relationship of carotid IMT and plaque with incident...

  3. [Prediction of coronary artery stenosis by measurement of total plaque area and thickness versus intima media thickness of the carotid artery].

    Science.gov (United States)

    Adams, Ansgar; Bojara, Waldemar

    2015-08-01

    Total plaque area (TPA), maximum plaque thickness and intima media thickness (IMT) in the carotid arteries of 431 patients aged 27-88 years were measured 1 day before a planned coronary artery angiography without any clinical knowledge about the patient. Age-related cut-off values of the TPA for the presence of coronary stenosis were evaluated. Using ultrasound four types of carotid artery atherosclerosis were identified. The accuracy of detection of cardiovascular coronary stenosis was 87% for types III and IVb. No type I patient had coronary stenosis. The IMT was significantly less predictive: the area under the curve (AUC) for TPA by age and plaque thickness was 0.82 (95% CI: 0.78-0.85) versus IMT 0.59 (95% CI: 0.54-0.64, p = 0.001). Prediction with TPA measurement by age and plaque thickness was better than TPA alone: AUC 0.82 (95% CI: 0.78-0.85) versus 0.77 (95% CI: 0.73-0.81, p = 0.0028), respectively. In a second cohort of 2566 healthy men and 1216 healthy women aged between 20 and 64 years who were examined in an occupational screening program, 11.2% of the men and 3.4% of the women showed a type III or IVb result. In the mean follow-up of period of 23.4 ± 14.4 months, 14 heart attacks, 7 bypass operations and 3 stent implantations occurred and 6 subjects showed coronary stenosis between 50% and 95% in coronary angiography. In the baseline examination 26 out of 30 patients showed a type III or IVb result. In the case of men and women with types III and IVb diagnosis by ultrasound, pharmaceutical treatment could be indicated in order to reduce the risk of cardiovascular events. Type I patients do not need preventive medication or coronary catheterization.

  4. Risk Factors for the Progression of Intima-Media Thickness of Carotid Arteries: A 2-Year Follow-Up Study in Patients with Newly Diagnosed Type 2 Diabetes

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    Sang Ouk Chin

    2013-10-01

    Full Text Available BackgroundIntima-media thickness (IMT of the carotid arteries is known to have a positive correlation with the risk of cardiovascular disease. This study was designed to identify risk factors affecting the progression of carotid IMT in patients with type 2 diabetes mellitus (T2DM.MethodsPatients with newly diagnosed T2DM with carotid IMT measurements were enrolled, and their clinical data and carotid IMT results at baseline and 2 years later were compared.ResultsOf the 171 patients, 67.2% of males and 50.8% of females had abnormal baseline IMT of the left common carotid artery. At baseline, systolic blood pressure, body mass index and smoking in male participants, and fasting plasma glucose and glycated hemoglobin levels in females were significantly higher in patients with abnormal IMT than in those with normal IMT. Low density lipoprotein cholesterol (LDL-C levels in males and high density lipoprotein cholesterol (HDL-C levels in females at the 2-year follow-up were significantly different between the nonprogression and the progression groups. Reduction of the United Kingdom Prospective Diabetes Study (UKPDS 10-year coronary heart disease (CHD risk score after 2 years was generally higher in the nonprogression group than the progression group.ConclusionLDL-C levels in males and HDL-C levels in females at the 2-year follow-up were significantly different between participants with and without progression of carotid IMT. Furthermore, a reduction in the UKPDS 10-year CHD risk score appeared to delay the advancement of atherosclerosis. Therefore, the importance of establishing the therapeutic goal of lipid profiles should be emphasized to prevent the progression of carotid IMT in newly diagnosed T2DM patients.

  5. Identification of the BCAR1-CFDP1-TMEM170A Locus as a Determinant of Carotid Intima-Media Thickness and Coronary Artery Disease Risk

    NARCIS (Netherlands)

    Gertow, Karl; Sennblad, Bengt; Strawbridge, Rona J.; Oehrvik, John; Zabaneh, Delilah; Shah, Sonia; Veglia, Fabrizio; Fava, Cristiano; Kavousi, Maryam; McLachlan, Stela; Kivimaeki, Mika; Bolton, Jennifer L.; Folkersen, Lasse; Gigante, Bruna; Leander, Karin; Vikstrom, Max; Larsson, Malin; Silveira, Angela; Deanfield, John; Voight, Benjamin F.; Fontanillas, Pierre; Sabater-Lleal, Maria; Colombo, Gualtiero I.; Kumari, Meena; Langenberg, Claudia; Wareham, Nick J.; Uitterlinden, Andre G.; Gabrielsen, Anders; Hedin, Ulf; Franco-Cereceda, Anders; Nyyssonen, Kristiina; Rauramaa, Rainer; Tuomainen, Tomi-Pekka; Savonen, Kai; Smit, Andries J.; Giral, Philippe; Mannarino, Elmo; Robertson, Christine M.; Talmud, Philippa J.; Hedblad, Bo; Hofman, Albert; Erdmann, Jeanette; Reilly, Muredach P.; O'Donnell, Christopher J.; Farrall, Martin; Clarke, Robert; Franzosi, Maria Grazia; Seedorf, Udo; Syvanen, Ann-Christine; Hansson, Goran K.; Eriksson, Per; Samani, Nilesh J.; Watkins, Hugh; Price, Jacqueline F.; Hingorani, Aroon D.; Melander, Olle; Witteman, Jacqueline C. M.; Baldassarre, Damiano; Tremoli, Elena; de Faire, Ulf; Humphries, Steve E.; Hamsten, Anders

    2012-01-01

    Background-Carotid intima-media thickness (cIMT) is a widely accepted marker of subclinical atherosclerosis. To date, large-scale investigations of genetic determinants of cIMT are sparse. Methods and Results-To identify cIMT-associated genes and genetic variants, a discovery analysis using the Illu

  6. Endothelial function predicts progression of carotid intima-media thickness

    DEFF Research Database (Denmark)

    Halcox, J.P.; Donald, A.E.; Ellins, E.;

    2009-01-01

    investigated endothelial dysfunction, risk factors, and progression of carotid intima-media thickness (cIMT) in late-middle-aged individuals at low to intermediate cardiovascular risk in a prospective study between 1997 and 2005. METHODS AND RESULTS: Brachial artery flow-mediated dilatation and cIMT were...... measured in 213 nonsmoking British civil servants recruited from a prospective cohort (Whitehall II study). Participants (age, 45 to 66 years) were free of clinical cardiovascular disease and diabetes mellitus. Risk factors and Framingham Risk Score were determined at baseline. cIMT was repeated 6...... to its impact on the evolution of the atherosclerotic substrate. Flow-mediated dilatation testing provides an integrated vascular measure that may aid the prediction of structural disease evolution and represents a potential short- to intermediate-term outcome measure for evaluation of preventive...

  7. Increased carotid intima-media thickness associated with high hs-CRP levels is a predictor of unstable coronary artery disease.

    Science.gov (United States)

    Abhashi, Sejran Ahmet; Kryeziu, Fadil Uke; Nazreku, Feim Durak

    2013-08-01

    Increased values of carotid intima-media thickness (CIMT) and high-sensitivity C-reactive protein (hs-CRP) are predictors of acute coronary events. We analysed the link between CIMT and hs-CRP in cases with coronary artery disease (CAD). From 1 January to 30 June 2012, we evaluated 43 patients with acute coronary syndrome (group A), 50 patients with stable coronary artery disease (group B) and 50 healthy volunteers (group C). All were analysed for CIMT and hs-CRP levels. CIMT values were higher in groups A and B (0.94 ± 0.21 mm, 0.89 ± 0.19 mm, respectively) and lower in group C (0.64 ± 0.09 mm), and this was statistically significant (p hs-CRP were higher in group A (1.87 ± 0.36 mg/l) and lower in groups B and C (1.07 ± 0.28 mg/l, 0.97 ± 0.45 mg/l, respectively) and this was also statistically significant (p < 0.0001).

  8. Correlation between Carotid Artery Intima-Media Thickness and Luminal Diameter with Body Mass Index and Other Cardiovascular Risk Factors in Adults

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    Sameeah A. Rashid

    2015-08-01

    Full Text Available Objectives: This study aimed to examine the correlation between carotid artery intima-media thickness (IMT and luminal diameter (LD with body mass index (BMI and other cardiovascular risk factors. Methods: This observational cross-sectional study took place between June 2013 and March 2014 in the Radiology Department of Rizgary Teaching Hospital in Erbil, Iraq. Non-randomly selected subjects ≥20 years old (n = 140 were divided into BMI groups and evaluated for the following cardiovascular risk factors: gender, age, hypertension (HTN, diabetes (DM, smoking, alcohol consumption, blood pressure, serum total cholesterol and triglyceride (TG levels. IMT and LD of the extracranial carotid arteries were measured by B-mode ultrasonography. Results: The mean IMT was 0.8 ± 0.3 mm, ranging from a total mean of 0.7 mm in the normal BMI group to 1.0 mm in the extremely obese group. A significant correlation was found between IMT and BMI (P = 0.04, but not between BMI and LD (P = 0.3. No significant difference in mean IMT or LD was seen between genders. Significant correlations were found between IMT and age, HTN, DM, high serum cholesterol and TG levels (P <0.001. An increase of one BMI unit caused a 0.009 mm increase in IMT and an increase of one year in age caused a 0.011 mm increase in IMT. Conclusion: Age, obesity, HTN, DM, high serum cholesterol and TG levels were found to have an impact on carotid IMT, which is a strong marker for the early development of atherosclerosis.

  9. Intima-Media Thickness in the Carotid and Femoral Arteries for Detection of Arteriosclerosis in Human Immunodeficiency Virus-Positive Individuals

    Science.gov (United States)

    Godoi, Emmanuelle Tenório Albuquerque Madruga; Brandt, Carlos Teixeira; Lacerda, Heloisa Ramos; Godoi, Jocelene Tenório Albuquerque Madruga; de Oliveira, Dinaldo Cavalcanti; Costa, Gabriela Farias Araujo Sousa; dos Santos Junior, Gerson Gomes; Leite, Kaliene Maria Estevão; Godoi, Juannicelle Tenório Albuquerque Madruga; de Vasconcelos, Adriana Ferraz

    2017-01-01

    Background The prevalence of atherosclerosis is higher in HIV-positive people, who also experience it earlier than the general population. Objectives To assess and compare the prevalence of atherosclerosis evaluated by the intima-media thickness of carotid and femoral arteries, and by the ankle-brachial pressure index (ABPI) in HIV patients treated or not treated with protease inhibitors (PIs) and controls. Methods Eighty HIV+ subjects (40 using PIs and 40 not using PIs) and 65 controls were included in the study. Atherosclerosis was diagnosed by (carotid and femoral) ITM measurement and ABPI. Classical risk factors for atherosclerosis and HIV were compared between the groups by statistical tests. A p ≤ 0.05 was considered significant. Results An IMT > P75 or the presence of plaque was higher in the HIV+ than in the control group (37.5% vs 19%, p = 0.04). Comparative analysis showed a significant difference (p=0.014) in carotid IMT between HIV+ with PIs (0.71 ± 0.28 mm), without PIs 0.63 ± 0.11 mm and, and controls (0.59 ± 0.11 mm). There was no significant difference in femoral IMT between the groups or in ABPI between HIV+ subjects and controls. However, a significant difference (p=0.015) was found between HIV+ patients not treated with PIs (1.17 [1.08 - 1.23]), and controls 1.08 [1.07 - 1.17]). Conclusion In HIV patients, atherosclerosis is more prevalent and seems to occur earlier with particular characteristics compared with HIV-negative subjects. PMID:28146208

  10. Evaluation of intima-media thickness of carotid artery in obese children by using ultrasound radiofrequency data based quality intima-media thickness technology%超声射频信号血管内中膜分析技术评价肥胖儿童颈动脉内中膜厚度

    Institute of Scientific and Technical Information of China (English)

    金晔; 汤庆娅; 陶晔璇; 薛敏波; 沈理笑; 陈亚青

    2011-01-01

    目的:应用超声射频信号血管内中膜分析(quality intima-media thickness,QIMT)技术测量肥胖儿童的颈动脉内中膜厚度(intima-media thickness,IMT),探讨肥胖儿童代谢异常状况与颈动脉IMT间的关系.方法:由1名高年资超声医师应用QIMT技术,测量32例肥胖儿童(肥胖组)和20名正常对照儿童(对照组)的双侧颈总动脉IMT.结果:肥胖组与对照组儿童的空腹血糖(FBG)、总胆固醇(TCH)及低密度脂蛋白(LDL)差异均无统计学意义(P>0.05);肥胖组儿童的三酰甘油(TG)高于对照组,差异有统计学意义(P<0.01),高密度脂蛋白(HDL)则明显低于对照组,差异有统计学意义(P<0.05);肥胖组儿童的颈总动脉IMT明显高于对照组,差异亦有统计学意义(P<0.01).结论:肥胖儿童的颈动脉IMT已开始增加,并可合并高脂血症,提示动脉硬化(AS)是可在小儿时期得病、成人发病.超声检查颈动脉IMT简便、安全无创,可作为早期发现AS的一个良好的预报因子.%Objective To study whether atherosclerosis begins in childhood by measuring the intima-media thickneas of carotid artery in obese children using ultrasound radiofrequency data based quality intima-media thickness (QIMT) technology. Methods Intima-media thickness of carotid artery was measured in 32 obese children and 20 healthy children (control group) by QIMT. Blood lipid profiles and fasting blood glucose were measured. Results There were no differences in fasting blood glucose, total cholesterol and low density lipoprotein levels between the two groups (P>0.05),however, high density lipoprotein level was lower (P<0.05) and triglyceride level was higher in obese group (P<0.01). The intima-media thickness of carotid artery in obese group was significantly higher than that in control group (P<0.01).Conclusion The increasing of carotid artery intima-mcdia thickness starts in childhood and might be associated with hyperlipidemia, this suggests that

  11. Peripheral Endothelial (DysFunction, Arterial Stiffness and Carotid Intima-Media Thickness in Patients after Kawasaki Disease: A Systematic Review and Meta-Analyses.

    Directory of Open Access Journals (Sweden)

    Sanne M Dietz

    Full Text Available Kawasaki disease (KD is a systemic pediatric vasculitis. Its main complication is the development of coronary arterial aneurysms (CAA, causing an increased risk for ischemia and myocardial infarction. It is unclear whether KD patients, apart from the presence of CAA, have an increased cardiovascular disease (CVD risk due to the previous systemic vasculitis. The aim of this study was to systematically review and meta-analyse the literature regarding surrogate markers for CVD risk in KD patients.Medline and Embase were searched for articles comparing endothelial dysfunction (flow-mediated dilation, nitroglycerin-mediated dilation and peripheral arterial tonometry, vascular stiffness (stiffness index, pulse wave velocity and carotid intima-media thickness (cIMT between patients and controls. Two investigators assessed the articles for eligibility and evaluated quality.Thirty studies were included. For all outcomes, moderate to high heterogeneity between studies was found. Most studies reported a decreased flow-mediated dilation in the whole KD- and CAA-positive group compared to controls, while data on CAA-negative patients were conflicting. The stiffness index was increased in the majority of studies evaluating the whole KD- and CAA-positive group, but not in most studies on CAA-negative patients. Mean cIMT was neither significantly increased in the whole KD-group nor in the CAA-positive group nor in most studies studying CAA-negative patients. Studies measuring maximum cIMT were conflicting.Literature suggests that surrogate markers for CVD risk in KD patients are increased in CAA-positive but not in CAA-negative patients. This may indicate that CAA-positive patients should be monitored for CVD in later life. The results of this review have to be interpreted with care due to substantial heterogeneity between studies and methodological limitations, as well as the lack of long-term follow-up studies.

  12. Arterial intima-media thickness in children heterozygous for familial hypercholesterolaemia.

    Science.gov (United States)

    Wiegman, Albert; de Groot, Eric; Hutten, Barbara A; Rodenburg, Jessica; Gort, Johan; Bakker, Henk D; Sijbrands, Eric J G; Kastelein, John J P

    2004-01-31

    Patients with familial hypercholesterolaemia have severe coronary-artery disease early in adult life. Whether lipid-lowering treatment should be started in childhood remains to be established. We therefore assessed 201 children heterozygous for familial hypercholesterolaemia and 80 unaffected siblings (both age ranges 8-18 years) with B-mode ultrasound to measure carotid wall intima-media thickness. Mean combined carotid intima-media thickness of heterozygotes was significantly greater than that of unaffected siblings (0.494 mm [SD 0.051] vs 0.472 [SD 0.049], p=0.002). A significant deviation in intima-media thickness was noted from age 12 years in children with familial hypercholesterolaemia. Findings on multivariate analysis showed LDL cholesterol, age, and sex to be strong and independent predictors of intima-media thickness. Since raised LDL cholesterol concentrations can be lowered efficiently, clinical studies are needed to investigate long-term safety and effectiveness of statin treatment in children with familial hypercholesterolaemia.

  13. Carotid Intima-Media Thickness in Master Athletes

    Science.gov (United States)

    Gori, Niccolo; Anania, Giuseppe; Stefani, Laura; Boddi, Maria; Galanti, Giorgio

    2015-01-01

    Background: Carotid Intima Media Thickness (IMT) is currently used to assess the relationship between progression of coronary and systemic atherosclerosis. To date, however, the possible impact of regular physical activity (PA) on this parameter has not been well estimated. Objectives: Our study aims to examine this aspect especially in the absence of cardiovascular (CV) risk factors. Patients and Methods: 100 master athletes (MA) and 51 sedentary controls (SC) were enrolled. They were evaluated by echo test with dedicated software (QIMT-Esaote) for IMT, and Bruce protocol and 2D echocardiography for cardiac hemodynamic parameters. Results: All values were within normal range. Left IMT mean values were significantly higher than right IMT values in both MA and SC groups (MA: IMT left 635 ± 104 µ, IMT right 614 ± 104 µ and mean IMT 624 ± 91.9 µ; SC: IMT left 633 ± 78 µ, IMT right 622 ± 90 µ and mean IMT 627 ± 78.1 µ). A positive relationship was found in both groups between IMT mean values and age (P risk factors, only age is associated with a slight increase of wall carotid thickening. The data are indicative of a physiological increase in IMT, as a consequence of increased peak effort systolic pressure after regular PA in athletes. PMID:26448832

  14. Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis

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    Rashid Nadeem

    2013-01-01

    Full Text Available Background. Obstructive sleep apnea (OSA is associated with coronary artery disease. Intermittent hypoxia associated with OSA increases sympathetic activity and may cause systemic inflammation, which may contribute to atherosclerosis leading to an increase in the size of carotid intima media thickness (CIMT. Methods. PubMed and Cochrane library were reviewed by utilizing different combinations of key words: sleep apnea, carotid disease, intima media thickness, and carotid atherosclerosis. Inclusion criteria were English articles; studies with adult population with OSA and without OSA; CIMT recorded by ultrasound in mean and standard deviation or median with 95% confidence interval; and OSA defined as apnea hypopnea index of ≥5/h. A total of 95 studies were reviewed for inclusion, with 16 studies being pooled for analysis. Results. Ninety-five studies were reviewed, while 16 studies were pooled for analysis; since some studies have more than one data set, there were 25 data sets with 1415 patients being pooled for meta-analysis. All studies used ultrasound to measure CIMT. CIMT standardized difference in means ranged from −0.883 to 8.01. The pooled standardized difference in means was 1.40 (lower limit 0.996 to upper limit 1.803, (P<0.0001. Conclusion. Patients with OSA appear to have increased CIMT suggestive of an atherosclerotic process.

  15. Does carotid intima-media thickness have relationship with polycystic ovary syndrome?

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    Zahra Allameh

    2013-01-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is a common reproductive endocrine disorder associated with cardiovascular disease (CVD risk factors and metabolic disturbances and a genetically heterogeneous disease. Intima-media thickness (IMT is an indicator of atherosclerosis. This study aimed to determine the relation between IMT and PCOS in women. Methods: This cross-sectional study was performed on 44 PCOS patients and 44 healthy women. Data collection included lipid profiles, blood pressure, waist circumference, body mass index (BMI, and common and internal IMT of carotid artery which were measured in studied subjects. IMT was measured by a radiologist using a linear 12 MHz ultrasound probe (LOGIC S6, GE in carotid setting. Results: IMT of common carotid artery (56.8 ΁ 7.6 in cases versus 49.8 ΁ 7.3 in controls, internal carotid artery (56.9 ΁ 6.03 in cases versus 49.6 ΁ 6.9 in controls, and both common and internal carotid artery (56.6 ΁ 6.7 in cases versus 49.7 ΁ 6.9 in controls were significantly higher in PCOS patients than healthy women (P < 0.001. Conclusions: In summary, results demonstrated that carotid artery thickness as a risk for premature atherosclerosis in patients with PCOS is higher than healthy subjects. And hence care and monitoring of PCOS women with these risk factors sounds to be important and necessary.

  16. The Relationship between Lichen Planus and Carotid Intima Media Thickness

    Science.gov (United States)

    C, Koseoglu; M, Erdogan; G, Koseoglu; O, Kurmus; AG, Ertem; TH, Efe; GI, Kurmus; T, Durmaz; T, Keles; E, Bozkurt

    2016-01-01

    Background Lichen planus (LP) is a chronic inflammatory disease. Although the association between chronic inflammation and subclinical atherosclerosis has been reported in the literature, the relationship between LP and carotid intima media thickness (CIMT) has not been previously investigated. The aim of this study was to investigate the relationship between LP and CIMT. Methods One hundred eleven LP patients and 105 controls were enrolled in the study. Then, CIMT examination was performed with an ultrasonography device. Cross-sectional associations of LP with CIMT were analyzed using linear regression models adjusted for related confounders. Results No statistical difference was found between LP and the controls except for the female gender, white blood cell, LDL cholesterol and triglycerides (p = 0.046, p = 0.019, p = 0.011 and p = 0.013, respectively). Significant difference was found between the groups in terms of CIMT (0.90 ± 0.2 mm vs. 0.61 ± 0.3 mm, p = 0.001). CIMT was correlated with longevity of the LP, but we did not find LP to be an independent predictor of increased CIMT in logistic regression analysis (r = 0.449, p < 0.001, β = -0.117, p = 0.092; respectively). Conclusions The results of our study suggested that LP was associated with increased mean CIMT, and furthermore that CIMT was correlated with longevity of LP. However, LP was not an independent predictor of increased CIMT. PMID:27899862

  17. Differences in left and right carotid intima-media thickness and the associated risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Luo, X. [Department of Ultrasound, Beijing An Zhen Hospital, Capital Medical University, Beijing (China); Yang, Y., E-mail: yangya99@126.co [Department of Ultrasound, Beijing An Zhen Hospital, Capital Medical University, Beijing (China); Cao, T. [Department of Ultrasound, Tangdu Hospital, Fourth Military Medical University, Xi' an (China); Li, Z. [Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan (China)

    2011-05-15

    Aim: To investigate the difference between the left and right carotid artery intima-media thickness (CIMT) with increasing age and to analyse the importance of the various risk factors associated with left and right CIMT, respectively. Materials and methods: Four hundred and forty-seven people were assigned into six groups based on age. CIMT and haemodynamic parameters of both carotid arteries were measured using the Quality Intima-Media Thickness (QIMT) technique. In addition, biochemical and anthropometric indices were also measured. Their associations were evaluated using simple and partial correlation analysis, adjusted for age. Results: Bilateral CIMTs became thicker with age (p < 0.001) and the left CIMT was significantly thicker compared with the right between the ages of 35 and 65 years (p = 0.01-0.05). In addition, the right CIMT thickened 10 years later compared with the left. Partial correlation analysis showed that the right CIMT correlated better with haemodynamic parameters compared with the left CIMT, but the left CIMT showed better correlation with biochemical indices. Conclusion: Haemodynamic and biochemical changes had different effects on the CIMT depending on the side affected. In addition, the left CIMT was thicker than the right between the ages of 35 and 65 years old.

  18. Carotid intima-media thickness in spondyloarthritis patients

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    Thelma Larocca Skare

    Full Text Available CONTEXT AND OBJECTIVE Accelerated atherosclerosis has become a major problem in rheumatic inflammatory disease. The aim here was to analyze carotid intima-media thickness (IMT in spondyloarthritis (SpA patients and correlate this with clinical parameters and inflammatory markers. DESIGN AND SETTING Cross-sectional analytical study at Rheumatology Outpatient Clinic, Evangelical University Hospital, Curitiba. METHODS IMTs (measured using Doppler ultrasonography of 36 SpA patients were compared with controls. The IMT in SpA patients was associated with inflammatory markers, like erythrocyte sedimentation rate (ESR, C-reactive protein (CRP and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; and with clinical parameters, like axial or peripheral involvement, dactylitis, HLA B27, uveitis occurrence, Bath Ankylosing Spondylitis Functional Index (BASFI and lipid profile. RESULTS The mean IMT in SpA patients was 0.72 ± 0.21 mm; in controls, 0.57 ± 0.13 mm (P = 0.0007. There were no associations with ESR, CRP, BASDAI or clinical data. In univariate analysis, greater IMT was seen in patients with longer disease duration (P = 0.014; Pearson R = 0.40; 95% confidence interval, CI = 0.06 to 0.65; higher triglycerides (P = 0.02; Spearman R = 0.37; 95% CI = 0.03 to 0.64; and older age (P = 0.0014; Pearson R 0.51; 95% CI = 0.21 to 0.72. CONCLUSION SpA patients have a higher degree of subclinical atherosclerosis than in controls, thus supporting clinical evidence of increased cardiovascular risk in rheumatic patients.

  19. Correlation between serum lipid profile and carotid intima-media thickness in Polycystic Ovarian Syndrome.

    Science.gov (United States)

    Saha, Sarama; Sarkar, Chandan; Biswas, Subhash Chandra; Karim, R

    2008-07-01

    Abnormal lipid profile is often found in women with Polycystic Ovary Syndrome. To assess the impact of abnormal lipid profile on atherosclerosis in young Polycystic Ovary Syndrome women, carotid intima-media thickness as judged by B-mode ultrasonography were done in 30 young (18-35 yrs) Polycystic Ovary Syndrome women and in similarly age-matched 30 apparently healthy controls. Compared to controls, young Polycystic Ovary Syndrome women had significantly elevated serum total cholesterol, triglyceride and LDL-C levels and carotid intima-media thickness. HDL-C level did not differ significantly between two groups of women. In Polycystic Ovary Syndrome women carotid intima-media thickness was positively correlated with serum total cholesterol, triglyceride and LDL-C and negatively correlated with serum HDL-C. Our study suggests that even young Polycystic Ovary Syndrome women are prone to atherosclerosis from early age.

  20. Carotid intima-media thickness in HIV patients treated with antiretroviral therapy

    DEFF Research Database (Denmark)

    Lebech, Anne-Mette; Wiinberg, Niels; Kristoffersen, Ulrik Sloth

    2007-01-01

    INTRODUCTION: Increased cardiovascular risk in HIV patients in antiretroviral therapy (ART) may be due to HIV infection, direct effect of ART or dyslipidaemia induced by ART. Our aim was to study the relative importance of HIV, ART and dyslipidaemia on atherosclerosis, assessed by the comparison...... of carotid artery intima-media thickness (IMT) in non-smoking HIV patients with high or low serum cholesterol levels as well as in healthy volunteers. METHODS: HIV patients in ART with normal cholesterol (or=6 x 5 mmol l(-1); n=12) as well as healthy controls (n=14) were included. All were non...... on these observations, one could speculate whether selective lowering of LDL cholesterol will be successful in reducing cardiovascular risk in non-smoking HIV patients....

  1. 高血压与颈动脉粥样硬化相关性的研究进展%Relationship between level of blood pressure and intima-media thickness of carotid artery

    Institute of Scientific and Technical Information of China (English)

    陈齐军; 刘彬; 杨潘杰; 曾文真

    2014-01-01

    The primary hypertension (PH) is a global multiple diseases, initially the main performance are blood pressure, then accompanied by multiple target organ damage and metabolic disorders of systemic disease. PH is an independent risk factor for atherosclerosis, which can lead atherosclerosis of aorta, carotid, cerebral artery, coronary, renal artery, superior mesenteric artery and limbs artery, causing cerebral vascular accident, coronary atherosclerotic heart disease, chronic renal failure and other serious diseases. Carotid artery is relatively superficial, the lesions appear earlier, and the examinations are noninvasive, convenient and accurate. The change of carotid intima-media thickness and atheromatous plaque, may well reflect the influence of PH on systemic atherosclerosis, as well as the relationship between different blood pressure and atherosclerosis. Therefore, early recognition and accurate assessment on carotid artery disease of patients with PH, would have great significance on early prevention, efficacy evaluation and prognosis of the disease.%原发性高血压是一种全球性多发性疾病,起初是以血压升高为主要表现,继而伴有多个靶器官功能损害和代谢紊乱的全身性疾病。原发性高血压是动脉粥样硬化的独立危险因素,可导致主动脉、颈动脉、脑动脉、冠状动脉、肾动脉、肠系膜动脉及四肢动脉等的粥样硬化,从而引发脑血管意外、冠状动脉粥样硬化性心脏病、慢性肾功能不全等严重疾病。颈动脉较为表浅,病变出现较早,颈动脉内膜-中膜厚度的改变及粥样斑块情况可较好地反映原发性高血压对全身动脉粥样硬化的影响,以及不同血压水平与动脉粥样硬化发生的关系。因此,对原发性高血压患者颈动脉病变的早期识别和准确评价,对疾病的早期防治和疗效评估及预后有重大意义。

  2. Relationship between carotid intima-media thickness and coronary angiographic findings: a prospective study

    Directory of Open Access Journals (Sweden)

    Kilickesmez Kadriye O

    2009-12-01

    Full Text Available Abstract Background Since cardiovascular diseases are associated with high mortality and generally undiagnosed before the onset of clinical findings, there is a need for a reliable tool for early diagnosis. Carotid intima-media thickness (CIMT is a non-invasive marker of coronary artery disease (CAD and is widely used in practice as an inexpensive, reliable, and reproducible method. In the current study, we aimed to investigate prospectively the relationship of CIMT with the presence and extent of significant coronary artery narrowing in patients evaluated by coronary angiography for stable angina pectoris. Methods One hundred consecutive patients with stable angina pectoris and documented ischemia on a stress test were included in the study. The patients were divided into two groups according to the result of the coronary angiography: group 1 (39 patients without a noncritical coronary lesion, and group 2 (61 patients having at least one lesion more than 50% within the main branches of the coronary arteries. All of the patients underwent carotid Doppler ultrasound examination for measurement of the CIMT by a radiologist blinded to the angiographic data. Results The mean CIMT was 0.78 ± 0.21 mm in Group 1, while it was 1.48 ± 0.28 mm in Group 2 (p = 0.001. The mean CIMT in patients with single vessel disease, multi-vessel disease, and left main coronary artery disease were significantly higher compared to Group 1 (1.2 ± 0.34 mm, p = 0.02; 1.6 ± 0.32 mm, p = 0.001; and 1.8 ± 0.31 mm, p = 0.0001, respectively. Logistic regression analysis identified CIMT (OR 4.3, p Conclusions The findings of this study show that increase in CIMT is associated with the presence and extent of CAD. In conclusion, we demonstrated the usefulness of carotid intima-media thickness in predicting coronary artery disease but large-scale studies are required to define its role in clinical practice.

  3. Lower carotid intima media thickness is predicted by higher serum bilirubin in both non-diabetic and Type 2 diabetic subjects

    NARCIS (Netherlands)

    Dullaart, Robin P. F.; Kappelle, Paul J.W.H.; de Vries, Rindert

    2012-01-01

    Background: Higher serum bilirubin levels may be implicated cardiovascular protection. It is unknown whether the impact of serum bilirubin on carotid artery intima media thickness (IMT), a marker of subclinical atherosclerosis, is different in diabetic subjects compared to non-diabetic subjects. We

  4. Effects of Nitric Oxide on Carotid Intima Media Thickness: A Pilot Study.

    Science.gov (United States)

    Lee, Edwin

    2016-06-01

    Cardiovascular disease is among the leading causes of morbidity and mortality worldwide. Preventive treatment of high-risk asymptomatic individuals depends on accurate prediction of a person's risk to develop a cardiovascular event. Currently, cardiovascular risk prediction in asymptomatic individuals is based on the level of cardiovascular risk factors incorporated in scoring equations. Improvement in cardiovascular risk prediction is needed because atherosclerosis underlies the occurrence of cardiovascular events, develops over decades, and has a prolonged asymptomatic phase during which it is possible to modify the course of the disease. The carotid intima media thickness test (CIMT) is a measure used to diagnose the extent of carotid atherosclerotic vascular disease. The test measures the thickness of the inner 2 layers of the carotid artery-the intima and media-and alerts physicians to any thickening when patients are still asymptomatic. Early detection may indicate the need for a more aggressive approach to managing the risk factors associated with heart disease and stroke. The role of nitric oxide (NO) in maintaining the integrity of the cardiovascular system is well established. Utilizing a dietary supplement that restores NO production, the author conducted a pilot study involving 10 patients with stable plague. Six months of treatment with the NO lozenge resulted in a statistically significant 10.9% reduction in CIMT. This pilot study suggests this approach may be a safe and effective strategy for patients with early stages of atherosclerotic vascular disease.

  5. Prevalence of peripheral vascular disease and its association with carotid intima-media thickness and arterial stiffness in type 2 diabetes: the Chennai urban rural epidemiology study (CURES 111).

    Science.gov (United States)

    Pradeepa, Rajendra; Chella, Sundarapandi; Surendar, Jayagopi; Indulekha, Karunakaran; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2014-05-01

    We investigated the prevalence of peripheral vascular disease (PVD) and its association with preclinical atherosclerotic markers [intima-media thickness (IMT)] and arterial stiffness among 1755 urban south Indian type 2 diabetic subjects recruited from the Chennai Urban Rural Epidemiology Study (CURES). Doppler studies were performed, and PVD was defined as ankle-brachial index (ABI) of ≤0.9. IMT of the common carotid artery was determined using high-resolution B-mode ultrasonography, and augmentation index (AGI) was measured using the Sphygmocor apparatus. The overall prevalence of PVD was 8.3% (age-standardized 6.5%). The prevalence of PVD was higher among known diabetic subjects (n = 1401) compared to newly detected diabetic subjects (n = 354) (8.6% vs 6.8%, p = 0.250). The mean IMT and AGI in subjects with PVD were significantly higher compared to subjects without PVD (IMT: 0.99 ± 0.26 mm vs 0.83 ± 0.19 mm; AGI: 28.1 ± 9.6% vs 25.7 ± 9.8%, respectively). IMT was independently associated with PVD even after adjusting for age [odds ratio (OR) = 2.9 (1.2-6.7), p = 0.016 for second tertile and OR = 3.9 (1.7-9.3), p = 0.002 for third tertile compared to first tertile]. AGI was also associated with PVD in the unadjusted model [OR = 1.8 (1.1-3.1), p = 0.027 for second tertile compared to first tertile]. However, when adjusted for age, the significance was lost. In conclusion, among urban south Indian type 2 diabetic subjects, the prevalence of PVD is 8.3% and IMT is more strongly associated with PVD than AGI.

  6. Comparison of semi-automated and manual measurements of carotid intima-media thickening.

    LENUS (Irish Health Repository)

    Mac Ananey, Oscar

    2014-01-01

    Carotid intima-media thickening (CIMT) is a marker of both arteriosclerotic and atherosclerotic risks. Technological advances have semiautomated CIMT image acquisition and quantification. Studies comparing manual and automated methods have yielded conflicting results possibly due to plaque inclusion in measurements. Low atherosclerotic risk subjects (n = 126) were recruited to minimise the effect of focal atherosclerotic lesions on CIMT variability. CIMT was assessed by high-resolution B-mode ultrasound (Philips HDX7E, Phillips, UK) images of the common carotid artery using both manual and semiautomated methods (QLAB, Phillips, UK). Intraclass correlation coefficient (ICC) and the mean differences of paired measurements (Bland-Altman method) were used to compare both methodologies. The ICC of manual (0.547 ± 0.095 mm) and automated (0.524 ± 0.068 mm) methods was R = 0.74 and an absolute mean bias ± SD of 0.023 ± 0.052 mm was observed. Interobserver and intraobserver ICC were greater for automated (R = 0.94 and 0.99) compared to manual (R = 0.72 and 0.88) methods. Although not considered to be clinically significant, manual measurements yielded higher values compared to automated measurements. Automated measurements were more reproducible and showed lower interobserver variation compared to manual measurements. These results offer important considerations for large epidemiological studies.

  7. Carotid intima-media thickness and elastic properties of aortas in normotensive children of hypertensive parents.

    Science.gov (United States)

    Yildirim, Ali; Kosger, Pelin; Ozdemir, Gokmen; Sahin, Fezan Mutlu; Ucar, Birsen; Kilic, Zubeyir

    2015-09-01

    A significant correlation between hypertension history and high blood pressure has been observed with regard to age, race and gender. Investigating carotid intima-media thickness and aortic stiffness prior to the development of hypertension in children of hypertensive parents enabled us to evaluate these patients for subclinical atherosclerosis. We compared carotid intima-media thickness, aortic strain, distensibility, stiffness indices and elastic modulus in 67 normotensive children whose parents had a diagnosis of essential hypertension and 39 normotensive children with no parental history of hypertension. Although there were no significant differences between the two groups in terms of systolic blood pressure, diastolic blood pressure, average blood pressure and pulse pressure (P>0.05), systolic blood pressures were higher among patients 15 years and older in the study group. No significant differences were noted between the control and study groups regarding interventricular septal thickness, left-ventricular posterior wall thickness, left-ventricular systolic and diastolic diameter and aortic annulus diameter (P>0.05). The left atrium diameter was larger in the study group compared with that in the control group, mainly because of the values of the 15-year-old and older children (P=0.01). The mean, maximum and minimum values of carotid intima-media thickness were significantly different in the study group compared with the control group among all age groups (Pchildren of hypertensive parents compared with the control group (P=0.014, P=0.001, respectively). Although there were no differences between the study and control groups regarding aortic strain, aortic distensibility, elastic modulus and stiffness indices (P>0.05), aortic distensibility was lower, and aortic stiffness indices were higher among children 15 years and older in the study group. An increase in the carotid intima-media thickness in all age groups and a decrease in aortic elastic properties in

  8. Increased Hs-CRP/adiponectin ratio is associated with increase carotid intima-media thickness

    OpenAIRE

    Liao, Huocheng; Li, Zhiming; Zheng, Dongdan; Liu, Jianping; Liu, Yan; Xiao, Chun; Wang, Hongguang

    2014-01-01

    Background High sensitivity C-reactive protein (Hs-CRP) and adiponectin (APN) are two critical cytokines and exert inverse effects on atherosclerosis initiation and progression. The purpose of our study was to investigate the value of Hs-CRP and ANP ratio (Hs-CRP/APN ratio) on evaluating atherosclerosis progression. Method One hundred sixty consecutive participants underwent carotid intima-media thickness (CIMT) measured by ultrasound were enrolled and drawn fasting blood samples for plasma l...

  9. Carotid Intima-Media Thickness and Plasma Asymmetric Dimethylarginine in Mexican Children Exposed to Inorganic Arsenic

    OpenAIRE

    Osorio-Yáñez, Citlalli; Ayllon-Vergara, Julio C.; Aguilar-Madrid, Guadalupe; Arreola-Mendoza, Laura; Hernández-Castellanos, Erika; Barrera-Hernández, Angel; De Vizcaya-Ruiz, Andrea; Del Razo, Luz M.

    2013-01-01

    Background: Arsenic exposure is a risk factor for atherosclerosis in adults, but there is little information on arsenic and early risk biomarkers for atherosclerosis in children. Carotid intima-media thickness (cIMT) is an indicator of subclinical atherosclerotic burden that has been associated with plasma asymmetric dimethylarginine (ADMA), a predictor of cardiovascular disease risk. Objectives: The aim of this study was to investigate associations of arsenic exposure with cIMT, ADMA, and en...

  10. CORRELATION BETWEEN CAROTID INTIMA MEDIA THICKNESS AND NEWLY DIAGNOSED HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    Rupak

    2015-09-01

    Full Text Available BACKGROUND: Hypertension is one of the leading causes of the global burden of disease and carotid intima - media thickness (IMT increases with hypertension. Various studies have proved that IMT measurements correlated with pathologic measurements. So the study has been done to find the correlation between carotid intima media thickness and hypertension in newly diagnosed cases. METHODS: 52 newly diagnosed hypertensive subjects ( A ge>18yrs were taken along with matched controls. Known hypertensive cases and secondary hypertension cases were excluded from the study. cIMT measurement was taken in all patients. RESULTS: mean age of cases was 42.8years and BMI was 26.3kg/m 2 . For all of the subjects combined (n=104, cIMT correlated with office systolic blood pressure (SBP (r = 0.48; p<0.001 but no correlation was found between diastolic blood pressure and cIMT(r=0.15, p=0.11. Among hypertensive subjects (n=52, there was a significant positive correlation between cIMT and SBP (r=0.59, p<0.001 but no correlation was found between DBP and cIMT (r = 0.202; p = 0.15 in the hypertensive subjects. No correlation was found between BMI and smoking with cIMT. CONCLUSION: Increase in blood pressure correlates with increase in carotid intima media thickness, particularly with systolic blood pressure.

  11. Functional Analysis of a Carotid Intima-Media Thickness Locus Implicates BCAR1 and Suggests a Causal Variant

    DEFF Research Database (Denmark)

    Boardman-Pretty, Freya; Smith, Andrew J. P.; Cooper, Jackie

    2015-01-01

    Carotid intima-media thickness (IMT) is a marker of subclinical atherosclerosis that can predict cardiovascular disease events over traditional risk factors. This study examined the BCAR1-CFDP1-TMEM170A locus on chromosome 16, associated with carotid IMT and coronary artery disease in the IMT...... associations of rs4888378 with BCAR1 in vascular tissues. Molecular studies suggest the lead SNP as a potentially causal SNP at the BCAR1-CFDP1-TMEM170A locus, and expression quantitative trait loci studies implicate BCAR1 as the causal gene. This variant showed stronger effects on common carotid IMT in women......, raising questions about the mechanism of the causal SNP on atherosclerosis....

  12. Residential Exposure to Urban Traffic Is Associated with Increased Carotid Intima-Media Thickness in Children

    Directory of Open Access Journals (Sweden)

    Rodrigo X. Armijos

    2015-01-01

    Full Text Available Chronic exposure to urban traffic pollution is documented to promote atherosclerosis in adults but little is known about its potential effects in children. Our study examined the association of long-term exposure to traffic with carotid intima-media thickness (cIMT in 287 healthy children. Residential proximity and distance-weighted traffic density (DWTD were used as proximity markers for traffic-related air pollution exposure. The multivariable analyses revealed that children residing <100 meters from the nearest heavily trafficked road had cIMT mean and maximum measurements that were increased by 15% and 11% compared to those living ≥ 200 meters away (P=0.0001. Similar increases in cIMT were identified for children in the highest versus lowest DWTD tertile. Children who resided 100–199 meters from traffic or in the middle DWTD tertile also exhibited increased cIMT but these differences were not statistically significant. No statistically significant differences were identified between residential distance to traffic or DWTD and systemic inflammation indicators (CRP, IL-6. The study results suggest that exposure to urban traffic promotes arterial remodeling in children. This finding is important since even small increases in cIMT over time can potentially lead to earlier progression to atherosclerosis. It is also important because traffic-related pollution is potentially modifiable.

  13. Validation of the Carotid Intima-Media Thickness Variability: Can Manual Segmentations Be Trusted as Ground Truth?

    Science.gov (United States)

    Meiburger, Kristen M; Molinari, Filippo; Wong, Justin; Aguilar, Luis; Gallo, Diego; Steinman, David A; Morbiducci, Umberto

    2016-07-01

    The common carotid artery intima-media thickness (IMT) is widely accepted and used as an indicator of atherosclerosis. Recent studies, however, have found that the irregularity of the IMT along the carotid artery wall has a stronger correlation with atherosclerosis than the IMT itself. We set out to validate IMT variability (IMTV), a parameter defined to assess IMT irregularities along the wall. In particular, we analyzed whether or not manual segmentations of the lumen-intima and media-adventitia can be considered reliable in calculation of the IMTV parameter. To do this, we used a total of 60 simulated ultrasound images with a priori IMT and IMTV values. The images, simulated using the Fast And Mechanistic Ultrasound Simulation software, presented five different morphologies, four nominal IMT values and three different levels of variability along the carotid artery wall (no variability, small variability and large variability). Three experts traced the lumen-intima (LI) and media-adventitia (MA) profiles, and two automated algorithms were employed to obtain the LI and MA profiles. One expert also re-traced the LI and MA profiles to test intra-reader variability. The average IMTV measurements of the profiles used to simulate the longitudinal B-mode images were 0.002 ± 0.002, 0.149 ± 0.035 and 0.286 ± 0.068 mm for the cases of no variability, small variability and large variability, respectively. The IMTV measurements of one of the automated algorithms were statistically similar (p > 0.05, Wilcoxon signed rank) when considering small and large variability, but non-significant when considering no variability (p truth. On the other hand, our automated algorithm was found to be more reliable, indicating how automated techniques could therefore foster analysis of the carotid artery intima-media thickness irregularity.

  14. Evaluation of intima media thickness of carotid arteries in 40-60 years old persons with type d personality and its comparison with normal ones

    Directory of Open Access Journals (Sweden)

    Fariborz Khorvash

    2013-01-01

    Conclusions: We conclude that type D personality increases the risk of cardiovascular diseases specially the stroke and myocardial infarction due to the higher prevalence of hormonal imbalances leading to arterial vasospasm and atherosclerotic disease. As a result, it is necessary to evaluate and treat these patients due to increased risk of atherosclerotic diseases, stoke, and myocardial infarction.

  15. Insulin sensitivity and carotid intima-media thickness

    DEFF Research Database (Denmark)

    Kozakova, Michaela; Natali, Andrea; Dekker, Jacqueline;

    2013-01-01

    Despite a wealth of experimental data in animal models, the independent association of insulin resistance with early carotid atherosclerosis in man has not been demonstrated. APPROACH AND RESULTS: We studied a European cohort of 525 men and 655 women (mean age, 44±8 years) free of conditions know...

  16. Association of mitral annulus calcification, aortic valve calcification with carotid intima media thickness

    Directory of Open Access Journals (Sweden)

    Scuteri Angelo

    2004-10-01

    Full Text Available Abstract Background Mitral annular calcification (MAC and aortic annular calcification (AVC may represent a manifestation of generalized atherosclerosis in the elederly. Alterations in vascular structure, as indexed by the intima media thickness (IMT, are also recognized as independent predictors of adverse cardiovascular outcomes. Aim To examine the relationship between the degree of calcification at mitral and/or aortic valve annulus and large artery structure (thickness. Methods We evaluated 102 consecutive patients who underwent transthoracic echocardiography and carotid artery echoDoppler for various indications; variables measured were: systemic blood pressure (BP, pulse pressure (PP=SBP-DBP, body mass index (BMI, fasting glucose, total, HDL, LDL chlolesterol, triglycerides, cIMT. The patients were divided according to a grading of valvular/annular lesions independent scores based on acoustic densitometry: 1 = annular/valvular sclerosis/calcification absence; 2 = annular/valvular sclerosis; 3 = annular calcification; 4 = annular-valvular calcification; 5 = valvular calcification with no recognition of the leaflets. Results Patient score was the highest observed for either valvular/annulus. Mean cIMT increased linearly with increasing valvular calcification score, ranging from 3.9 ± 0.48 mm in controls to 12.9 ± 1.8 mm in those subjects scored 5 (p 0.0001. Conclusion MAC and AVC score can identify subgroups of patients with different cIMT values which indicate different incidence and prevalence of systemic artery diseases. This data may confirm MAC-AVC as a useful important diagnostic parameter of systemic atherosclerotic disease.

  17. Carotid Artery Intima-Media Thickness and Cutaneous Microvascular Function are Associated With Vitamin C Levels in Young Patients With Type 1 Diabetes

    DEFF Research Database (Denmark)

    Odermarsky, Michal; Lykkesfeldt, Jens; Liuba, Petru

    2008-01-01

    Background: Vascular endothelial dysfunction and accelerated thickening of arterial intima contribute to increased cardiovascular morbidity in type 1 diabetes. Although vitamin C has important antioxidant functions, and increased oxidative stress is a central mechanism of vascular abnormalities......, and the measured skin perfusion was expressed as % maximal increase from baseline. Markers of systemic inflammation (C-reactive protein, fibrinogen and orosomucoid), lipids (total, LDL and HDL cholesterol) and glycosylated hemoglobin (HbA1c) were measured in EDTA plasma. Ascorbate was analyzed in meta......-phosphoric acid-stabilized EDTA-plasma by high-performance liquid chromatography. Results: In univariate regression analysis, both cIMT and skin microvascular response to ACH correlated with ascorbate levels (r=-0.29; p=0.04, and r=0.43; p=0.004 respectively). The relationships between these vascular indexes...

  18. Relationship Between Carotid Intima-Media Thickness Using Ultrasonography and Diagnostic Indices of Metabolic Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kyung Sun; Heo, Kyung Hwa; Won, Yong Lim; Kim, Ki Woong [Center for Occupational Disease Reserach, Occupational Safety and Health Research Insurance, KOSHA, Incheon (Korea, Republic of)

    2009-09-15

    The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipment and the NCEP-ATP III criteria were used to define MetS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was 0.739{+-}0.137 mm and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=-0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.

  19. Anisotropic diffusion filter based edge enhancement for the segmentation of carotid intima-media layer in ultrasound images using variational level set method without re-initialisation.

    Science.gov (United States)

    Sumathi, K; Anandh, K R; Mahesh, V; Ramakrishnan, S

    2014-01-01

    In this work an attempt has been made to enhance the edges and segment the boundary of intima-media layer of Common Carotid Artery (CCA) using anisotropic diffusion filter and level set method. Ultrasound B mode longitudinal images of normal and abnormal images of common carotid arteries are used in this study. The images are subjected to anisotropic diffusion filter to generate edge map. This edge map is used as a stopping boundary in variational level set method without re-initialisation to segment the intima-media layer. Geometric features are extracted from this layer and analyzed statistically. Results show that anisotropic diffusion filtering is able to extract the edges in both normal and abnormal images. The obtained edge maps are found to have high contrast and sharp edges. The edge based variational level set method is able to segment the intima-media layer precisely from common carotid artery. The extracted geometrical features such as major axis and extent are found to be statistically significant in differentiating normal and abnormal images. Thus this study seems to be clinically useful in diagnosis of cardiovascular disease.

  20. Serum calcium level is related to both intima-media thickness and carotid atherosclerosis: a neglect risk factor in obese/overweight subjects

    Directory of Open Access Journals (Sweden)

    Montalcini Tiziana

    2012-06-01

    Full Text Available Abstract Background Experimental studies suggested that high serum calcium may be important in the pathogenesis of vascular diseases. Since calcium seems to affect specifically the cerebrovascular district, aim of this study was to determine the relation between serum calcium levels, within normal range, and subclinical atherosclerosis in the carotid arteries, in a population of obese/overweight subjects. Methods In our retrospective study we included 472 subjects (59% female with body mass index equal to or more than 25 kg/m2. They underwent a physical examination, a biochemical assessment (including calcium evaluation and a B-mode ultrasonography of the extracranial carotid arteries to detect carotid atherosclerosis presence and to measure intima-media thickness. Results Mean age of the population was 50 ±12 years. Prevalence of the Carotid atherosclerosis was 40%. Mean carotid intima-media thickness was 0,66 ± 0,18 mm. The univariate and multivariate analysis showed an association between calcium and carotid intima-media thickness (p = 0,035. We divided the population in serum calcium tertiles. We found an higher carotid atherosclerosis prevalence in the III tertile in comparison to that of the I tertile (p = 0,039. Conclusions In this study we found a positive relation between serum calcium levels, within normal range, and subclinical atherosclerosis in the carotid arteries, in a population of obese/overweight subjects. It is important to consider the impact of the serum calcium levels in the overall risk assessment of patients, at least in obese subjects.

  1. Posttraumatic stress disorder, combat exposure, and carotid intima-media thickness in male twins.

    Science.gov (United States)

    Goetz, Margarethe; Shah, Amit; Goldberg, Jack; Cheema, Faiz; Shallenberger, Lucy; Murrah, Nancy V; Bremner, J Douglas; Vaccarino, Viola

    2014-11-15

    Posttraumatic stress disorder (PTSD) is associated with an increased risk of ischemic heart disease, though the pathophysiologic mechanisms remain unclear. Carotid artery intima-media thickness (CIMT) is a measure of subclinical atherosclerosis. We examined whether PTSD and combat exposure were associated with CIMT in Vietnam War-era twins after controlling for shared genetic and childhood factors. Between 2002 and 2010, we studied 465 middle-aged twins from the Vietnam Era Twin Registry who were free from cardiovascular disease. PTSD was diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and CIMT was measured by ultrasound. Mixed-effects regression models were used to examine individual, between-pair, and within-pair associations. Approximately 13% of participants met the criteria for PTSD, and 45% served in the Vietnam Theater. PTSD was associated with 32.7 μm higher CIMT (95% confidence interval (CI): 0.9, 64.5) after adjustment for confounders. The average CIMT for the pair increased by 59.7 μm for each additional twin with PTSD (95% CI: 15.9, 104.2). We found no significant within-pair differences in CIMT when comparing PTSD-discordant co-twins. Results for combat exposure were similar, but its association with CIMT weakened after adjustment for PTSD (95% CI: 7.0, 45.3). Among Vietnam War-era veterans, combat exposure and PTSD are associated with CIMT, though the associations are largely mediated by shared childhood factors.

  2. [Carotid intima-media thickness; normal values from 4 years].

    Science.gov (United States)

    de Arriba Muñoz, Antonio; Domínguez Cajal, María Mercedes; Labarta Aizpún, José Ignacio; Domínguez Cunchillos, Manuel; Mayayo Dehesa, Esteban; Ferrández Longás, Ángel

    2013-01-01

    Introducción: El estudio de la arteria carotídea común mediante ultrasonidos, cada vez cobra mayor importancia para la prevención, tratamiento y evaluación del riesgo de desarrollar enfermedad cardiovascular. Un aumento del índice íntima-media se asocia con la presencia de otros factores cardiovasculares, enfermedad cardiovascular y cerebrovascular y ateroesclerosis en otras zonas del sistema vascular tanto en adultos como en población pediátrica. Material y métodos: Estudio transversal en 202 niños sanos de edades comprendidas entre 4 y 15 años en los que se han valorado parámetros auxológicos, tensión arterial sistólica y diastólica e índice íntima-media carotídea. Resultados: La muestra se compone de 100 varones y 102 mujeres, sin que existan diferencias entre ellos respecto al sexo; se presentan representaciones gráficas de los valores de índice íntima-media carotídea tanto en el total de la muestra como por sexos; existe una correlación positiva entre el índice íntima-media carotídeo con la edad (r = 0,229, p 0,01) y el IMC (r = 0,212, p media es un factor añadido para una identificación precoz de enfermedad cardiovascular y de su evolución tanto en población adulta como pediátrica.

  3. Effect of rosuvastatin on the echolucency of the common carotid intima-media in low-risk individuals: the METEOR trial

    NARCIS (Netherlands)

    Lind, L.; Peters, S.A.; Ruijter, H.M. Den; Palmer, M.K.; Grobbee, D.E.; Crouse, J.R.; O'Leary, D.H.; Evans, G.W.; Raichlen, J.S.; Bots, M.L.; Goldstein, M.; Staessen, J.A.; Marchal, G.; Linhart, A.; Salonen, J.T.; Simon, A.

    2012-01-01

    BACKGROUND: The echolucency of the carotid intima-media is related to increased cardiovascular risk factor levels, morbidity, and mortality. The aim of this study was to assess the effect of statins on the echolucency of the common carotid intima-media in a low-risk population. METHODS: Data from th

  4. Effect of cabergoline on insulin sensitivity, inflammation, and carotid intima media thickness in patients with prolactinoma.

    Science.gov (United States)

    Inancli, Serap Soytac; Usluogullari, Alper; Ustu, Yusuf; Caner, Sedat; Tam, Abbas Ali; Ersoy, Reyhan; Cakir, Bekir

    2013-08-01

    The aim of this study was to evaluate the effect of Cabergoline on insulin sensitivity, inflammatory markers, and carotid intima media thickness in prolactinoma patients. Twenty-one female, newly diagnosed patients with prolactinoma were included in the study. None of the patients were treated previously. Cabergoline was given as treatment, starting with 0.5 mg/day and tapered necessarily. Blood samples were taken for prolactin, highly sensitive C-reactive protein, homocysteine, total cholesterol, low density lipoprotein (LDL) cholesterol, fasting glucose, insulin, and HOMA (homeostasis model assessment of insulin resistance) score was calculated, prior to and 6 months after starting treatment. The body mass index (BMI) was measured and carotid intima media thickness (CIMT) was evaluated for each patient prior to and 6 months after the treatment. The prolactin levels and LDL decreased significantly after cabergoline treatment. Insulin sensitivity improved independently from the decrease in prolactin levels and BMI. The significant decrease in homocysteine and hs-CRP was not related with the decrease in prolactin levels. The significant decrease in CIMT was independent from the decrease in prolactin levels, HOMA score, and BMI. Our data suggest that cabergoline treatment causes an improvement in insulin sensitivity and inflammatory markers and causes a decrease in CIMT independent from the decrease in prolactin, LDL cholesterol, and BMI. We conclude that short term cabergoline treatment can improve endothelial function independently from the changes in metabolic disturbances and inflammatory markers.

  5. Associations of carotid intima-media thickness, tobacco smoking and overweight with hearing disorder in a general population sample.

    Science.gov (United States)

    John, U; Baumeister, S E; Kessler, C; Völzke, H

    2007-11-01

    It has been argued that smoking or overweight might contribute to hearing disorder by atherogenic narrowing of the nutrient arteries to the cochlea. The carotid intima-media thickness (CIMT) is a surrogate marker for generalized atherosclerosis. We analyzed a subgroup (n=2619) from a general population sample in north-eastern Germany aged 45-81 years (Study of Health in Pomerania, SHIP). Assessments included self-statements about hearing disorder and medical examinations of CIMT. Using ordinal logistic regression for data analysis and after adjustment for cigarettes per day, waist circumference, diabetes, exposure to noise, age and sex, we found CIMT remained a predictor of hearing disorder (odds ratio 1.8, 95% confidence interval 1.0-3.2). Cigarettes per day and waist circumference were related to CIMT but not to hearing disorder. The findings suggest a positive association between CIMT and hearing disorder.

  6. The Relationship between the 24 h Blood Pressure Variability and Carotid Intima-Media Thickness: A Compared Study

    Directory of Open Access Journals (Sweden)

    Huahua Xiong

    2014-01-01

    Full Text Available Large blood pressure variability (BPV will not only harm the target organ but also increase the possibility of the cardiovascular events. Since the damage of vascular system always leads to the alteration of the carotid wall, the structure and function of the carotid artery have been extensively examined in previous studies. In this work we conduct a study (60 subjects, aged 33–79 to evaluate the relationship between BPV and carotid intima-media thickness (IMT in Shenzhen, which is one large city in the southern area of China. In our study, the blood pressure (BP was collected using the 24 h ambulatory BP monitoring, and the BPV was evaluated using standard deviation (SD, coefficient of variation (CV, and average real variability (ARV during 24 h, daytime and nighttime. All the IMT measurements are collected by ultrasound. The results show that both the daytime, and 24 h systolic BPV evaluated by three indices are positively associated with IMT. Among them, daytime systolic BPV evaluated with ARV is the best variable to represent the increasing of carotid IMT. In addition, after adjusting by age, sex, smoking, hypertension, and mean BP and PP values, 24 h diastolic BPV evaluated with SD also presents the favorable performance.

  7. 2型糖尿病患者血清瘦素与颈动脉内膜中层厚度的相关性研究%Association of serum leptin with intima-media thickness of carotid artery in type 2 diabetes patients

    Institute of Scientific and Technical Information of China (English)

    刘振华; 毕会民; 贺艳菊; 张玉国

    2009-01-01

    Objective To investigate the relationship between serum leptin and carotid intima-media thickness in patients with type 2 diabetes mellitus. Methods 35 patients with type 2 diabetes mellitus (DM) and 16 normal controls were studied. Fasting serum leptin, fasting glucose(FBG), HbAlc, C-peptide, lipide, systolic(SBP), diastolic blood pressure(DBP), body mass index (BMI) and waist circ-umference (WC) were measured in all subjects. The intima-media thickness (IMT) of common carotid artery was measured by high-resolu-tion ultrasound imaging. Results IMT of T2DM was positively correlated with leptin concentration. Conclusion Serum leptin concentra-tion is independently associated with the IMT of carotid artery, which suggest that leptin may be an independent risk factor of atherosclerosis.%目的 探讨2型糖尿病(T2DM)患者血清瘦素水平与颈动脉内膜中层厚度(IMT)的关系.方法 选择35例2型糖尿痛患者、16例正常对照者,分别测定其血清瘦素、空腹血糖、糖化血红蛋白AIc(HbAlc)、C肽、血脂、血压、体重指数(BMI)及腰围,同时使用高分辨率超声检测双侧颈动脉IMT.结果 T2DM患者血清瘦素浓度与颈动脉IMT呈显著正相关.结论 血清瘦素浓度与颈动脉IMT的增厚有关,提示瘦素可能是导致T2DM患者动脉粥样硬化中的一项危险因素.

  8. Common carotid intima-media thickness and von Willebrand factor serum levels in rheumatoid arthritis female patients without cardiovascular risk factors.

    Science.gov (United States)

    Daza, Leonel; Aguirre, Martin; Jimenez, Martin; Herrera, Rafael; Bollain, J J

    2007-04-01

    High atherosclerosis prevalence was found in rheumatoid arthritis (RA), and the von Willebrand factor (vWF) was shown to be a marker for endothelial damage. The aim of this study was to evaluate the association of intima-media thickness of the left common carotid artery with vWF serum levels in rheumatoid arthritis patients without cardiovascular risk factors. We included 55 RA female patients, each with at least 5 years of duration of the disease, and 20 healthy female subjects as members of the control group. The vWF, cholesterol, triglycerides, and the immune variables-rheumatoid factor and reactive C protein-were evaluated. The media thickness and intima-media thickness (IMT) in patients and in the control subjects were assessed by Doppler ultrasound of the left common carotid artery. Although the ages for RA patients and healthy female controls were not different, the IMT of the left common carotid artery (IMT CCA) in rheumatoid arthritis patients was increased in comparison with healthy control measurements, the mean being 0.67 mm (SD 0.18) vs 0.58 mm (SD 0.10) with a p value 0.01. The vWF serum levels showed differences in RA patients from those in control patients, 145.6 (SD 30.08) vs 121.8 (SD 37.17), respectively, with p=0.007. A correlation was also found between vWF with IMT CCA in the RA patients: r=0.390 and p<0.05. We concluded that the measurements of the left common carotid artery intima-media thickness together with the von Willebrand factor serum levels could give valuable information about the artery status and the atherosclerosis process in early stages in patients with rheumatoid arthritis without cardiovascular risk factors.

  9. Soluble CD93 Is Involved in Metabolic Dysregulation but Does Not Influence Carotid Intima-Media Thickness

    NARCIS (Netherlands)

    Strawbridge, Rona J.; Hilding, Agneta; Silveira, Angela; Osterholm, Cecilia; Sennblad, Bengt; McLeod, Olga; Tsikrika, Panagiota; Foroogh, Fariba; Tremoli, Elena; Baldassarre, Damiano; Veglia, Fabrizio; Rauramaa, Rainer; Smit, Andries J.; Giral, Phillipe; Kurl, Sudhir; Mannarino, Elmo; Grossi, Enzo; Syvanen, Ann-Christine; Humphries, Steve E.; de Faire, Ulf; Ostenson, Claes-Goran; Maegdefessel, Lars; Hamsten, Anders; Backlund, Alexandra

    2016-01-01

    Type 2 diabetes and cardiovascular disease are complex disorders involving metabolic and inflammatory mechanisms. Here we investigated whether sCD93, a group XIV c-type lectin of the endosialin family, plays a role in metabolic dysregulation or carotid intima-media thickness (IMT). Although no assoc

  10. Carotid intima media thickness is associated with plasma adiponectin but not with the leptin : adiponectin ratio independently of metabolic syndrome

    NARCIS (Netherlands)

    Dullaart, Robin P. F.; Kappelle, Paul J.W.H.; Dallinga-Thie, Geesje M.

    2010-01-01

    Purpose: A recent report showed no benefit of the leptin: adiponectin ratio (L: A ratio) over individual adipokine levels in CHD prediction [ 8]. We determined associations of carotid intima media thickness (IMT) with the L: A ratio taking account of cardiovascular risk factors in a high risk popula

  11. Associations of cardiovascular risk factors, carotid intima-media thickness and manifest atherosclerotic vascular disease with carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Liira Helena

    2011-04-01

    Full Text Available Abstract Background The role of atherosclerosis in carpal tunnel syndrome (CTS has not previously been addressed in population studies. The aim of this study was to investigate the associations of cardiovascular risk factors, carotid artery intima-media thickness (IMT, and clinical atherosclerotic diseases with CTS. Methods In this cross sectional study, the target population consisted of subjects aged 30 or over who had participated in the national Finnish Health Survey in 2000-2001. Of the 7977 eligible subjects, 6254 (78.4% were included in our study. Carotid IMT was measured in a sub-sample of subjects aged 45 to 74 (N = 1353. Results Obesity (adjusted odds ratio (OR 2.4, 95% confidence interval (CI 1.1-5.4, high LDL cholesterol (OR 3.8, 95% CI 1.6-9.1 for >190 vs. 200 vs. Conclusions Our findings suggest an association between CTS and cardiovascular risk factors in young people, and carotid IMT and clinical atherosclerotic vascular disease in older people. CTS may either be a manifestation of atherosclerosis, or both conditions may share similar risk factors.

  12. Association between fasting and postprandial triglyceride levels and carotid intima-media thickness in type 2 diabetes patients

    Institute of Scientific and Technical Information of China (English)

    陈香; 田浩明; 刘瑞

    2003-01-01

    Objective To investigate the association of fasting and postpiandial triglyceride with carotid intima-media thickness among type 2 diabetic patients in southeast China.Methods A total of 78 type 2 diabetic patients from southeast China were recruited. All the subjects underwent a standardized mixed-meal test (SMMT) and an oral glucose tolerance test. Carotid intima-media thickness (IMT) was measured by color doppler ultrasound examination.Results Postprandial triglyceride (PTG) after SMMT increased significantly in type 2 diabetic patients. The carotid IMT in patients with postprandial hypertriglyceridemia was sinificantly greater than that in patients with postprandial normal-triglyceridemia (0.90 mm vs 0.81 mm, P0.05).Conclusion The results suggest that postprandial hypertriglyeridemia may be an independent risk factor of early atherosclerosis in type 2 diabetes.

  13. Soya isoflavone consumption in relation to carotid intima-media thickness in Chinese equol excretors aged 40-65 years.

    Science.gov (United States)

    Cai, Yun; Guo, Kaiping; Chen, Chaogang; Wang, Ping; Zhang, Bo; Zhou, Quan; Mei, Fang; Su, Yixiang

    2012-11-14

    Previous studies have suggested that the daidzein metabolite equol rather than daidzein itself contributes to the beneficial effect of soya foods in the prevention of CVD. The aim of the present study is to examine the proportion of equol excretion in Chinese adults and compare plasma lipids and carotid artery intima-media thickness (IMT) between equol excretors and non-excretors, and to evaluate the effect of soya isoflavone intakes on serum lipids and IMT in either equol excretors or non-excretors. Subjects (n 572; women n 362, men n 210) were recruited for the present study. An overnight urine sample was provided by each subject on their usual diet to quantify urinary concentrations of daidzein and equol. Far-wall IMT was determined by B-mode ultrasound in the right carotid at two sites, carotid bulb (CB-IMT) and common carotid artery (CCA-IMT), and fasting serum lipids were measured. Habitual dietary intakes were estimated with a FFQ, and soya isoflavone intake derived from the FFQ was assessed. Of the 572 subjects, the proportion of equol excretors on their usual diet was 25·0 % (n 143). Compared with non-excretors, equol excretors showed significantly lower serum TAG (-38·2 (95 % CI -70·4, -5·9) %, P = 0·012) and CCA-IMT (-4·9 (95 % CI -9·7, -0·3) %, P = 0·033). Equol excretors with higher daily isoflavone intakes (-5·4 mg/d) had significantly lower IMT (-16·2 %, P = 0·035) and tended to have higher HDL-cholesterol (P = 0·055) than did those with lower daily isoflavone intakes (1·5 mg/d), while no association was observed between soya isoflavone intakes and serum lipids or IMT in non-excretors. In conclusion, the benefits of soya isoflavones in preventing CVD may be apparent among equol excretors only.

  14. Inverse association of serum vitamin D in relation to carotid intima-media thickness in Chinese postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Yaping Hao

    Full Text Available This study aimed to investigate the relationship between serum vitamin D level and carotid intima-media thickness (C-IMT in Chinese postmenopausal women.Nine hundred and twenty six Chinese postmenopausal women without carotid artery plaque or history of cardiovascular disease were selected for analysis. Measurements of serum 25 hydroxyvitamin D3 (25(OHD3 concentration and C-IMT were made by electrochemiluminescence immunoassay and B-mode ultrasound, respectively. Trend analysis was conducted according to tertiles of C-IMT.The median serum 25(OHD3 level was 11.03 ng/mL, with an interquartile range of 8.22-14.70. A decreasing trend of serum 25(OHD3 level was accompanied by increased C-IMT tertiles (P for trend = 0.001. Correlation analysis found an inverse relationship between serum 25(OHD3 level and C-IMT (r = -0.113, P = 0.001. After adjustment for confounding factors, multiple regression analysis showed that serum 25(OHD3 level independently and negatively associated with C-IMT (Standard β = -0.112, P < 0.001. Moreover, the inverse correlation of serum 25(OHD3 with C-IMT was also found in a subgroup of women with normal glucose tolerance, blood pressure and body mass index, and without undergoing lipid-lowering therapy (standard β = -0.140, P = 0.018.Serum 25(OHD3 level was inversely correlated with C-IMT in Chinese postmenopausal women.

  15. Correlation between Common Carotid Artery Intima-media Thickness and Degree of Retinopathy in Type 2 Diabetes Mellitus%2型糖尿病视网膜病变程度与颈总动脉内-中膜厚度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李晶晶; 邓又斌; 杨顺实

    2011-01-01

    目的 评估2型糖尿病患者(diabetes mellitus,DM)视网膜病变程度与颈总动脉内-中膜厚度(common carotid artery inti-ma-media thickness,CCA IMT)的相关性,以期早期发现糖尿病视网膜病变(diabetic retinopathy,DR)并评估其病变程度.方法 筛选2型糖尿病患者84例.根据眼底荧光造影的结果分为糖尿病无视网膜病变(non-diabetic retinopathy,NDR)组、非增殖期糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组及增殖期糖尿病视网膜病变(proliferative di-abetic retinopathy,PDR)组三组.记录各组病例的性别、年龄、糖尿病病程,测量其CCA IMT、空腹血糖(fasting blood glu-cose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、血清甘油三脂(serum triglycerides,TG)、总胆固醇(totalcholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholestero,LDL-C)及高密度脂蛋白胆固醇(high-density lipo-protein cholesterol,HDL-C).结果 CCA IMT、FBG、HbA1c及糖尿病病程均同DR的程度具有正相关性(P<0.05);且排除了FBG、HbA1c及糖尿病病程的影响后,CCA IMT仍与DR程度相关(P<0.01).结论 2型糖尿病患者DR的程度同CCA IMT具有正相关性.%Objective To estimate the correlation between the degree of the diabetic retinopathy(DR)and the common carotid artery intima-media thickness (CCA IMT)in type 2 diabetes mellitus(DM)for early detection of DR and the the extent of their lesions. Methods A total of 84 patients with type 2 diabetes mellitus,according to the result of fundus fluorescein angiography,were divided into three groups:non-diabetic retinopathy(NDR)group,non-proliferative diabetic retinopathy(NPDR)group and proliferative diabetic retinopathy(PDR)group. In each group, gender, age and duration of diabetes were recorded, and common carotid artery intima-media thickness(CCA IMT), fasting blood glucose (FBG) ,glycosylated hemoglobin( HbAlc), serum triglycerides(TG), total cholesterol(TC), low

  16. Association of Plasma Adiponectin and Oxidized Low-Density Lipoprotein with Carotid Intima-Media Thickness in Diabetic Nephropathy

    OpenAIRE

    Anna Tavridou; Anastasia Georgoulidou; Athanasios Roumeliotis; Stefanos Roumeliotis; Efstathia Giannakopoulou; Nikolaos Papanas; Ploumis Passadakis; Manolopoulos, Vangelis G; Vassilis Vargemezis

    2015-01-01

    Aims. We sought to determine the association between levels of adiponectin and oxidized low-density lipoprotein (ox-LDL) in patients with diabetic nephropathy as well as their effect on carotid intima-media thickness (cIMT). Methods. Adiponectin and ox-LDL were determined in 25 diabetic patients without nephropathy and 94 patients at different stages of diabetic nephropathy including subjects on hemodialysis. cIMT was measured using real-time B-mode ultrasonography. Results. Plasma adiponecti...

  17. Increased carotid intima media thickness is associated with prolactin levels in subjects with untreated prolactinoma: a pilot study.

    Science.gov (United States)

    Jiang, Xiao-Bing; Li, Cui-Ling; He, Dong-Sheng; Mao, Zhi-Gang; Liu, Dong-Hong; Fan, Xiang; Hu, Bin; Zhu, Yong-Hong; Wang, Hai-Jun

    2014-06-01

    Hyperprolactinemia is associated with endothelial dysfunction and atherogenic risk factors, but carotid intima media thickness (IMT) has not been studied in hyperprolactinemic patients. To determine whether untreated hyperprolactinemia contributes to increased carotid IMT. Thirty-one prolactinoma patients and 60 healthy controls were respectively studied. Participants underwent hormone evaluation. Anthropometric parameters (body mass index and blood pressure), inflammatory markers (high-sensitivity C-reactive protein and fibrinogen), serum glucose, insulin, lipid and apolipoprotein profiles were also determined. Endothelial function measured as the flow-mediated dilation (FMD) of a brachial artery and carotid IMT were evaluated using high-resolution ultrasonography. Multivariate linear regression analysis was applied to identify independent determinants of FMD and carotid IMT. Triglycerides, homeostasis model assessment of insulin resistance, apolipoprotein (apo)B/apoA-I ratio, high-sensitivity C-reactive protein (hsCRP) and fibrinogen were significantly higher, while apoA-I was significantly lower in patients with prolactinomas than in the controls. Meanwhile, decreased FMD and increased carotid IMT were observed in hyperprolactinemic group. Serum prolactin was positively correlated with triglycerides, apoB/apoA-I ratio, hypogonadal, hsCRP and fibrinogen (P < 0.05), but inversely associated with apoA-I and HDL-C (P ≤ 0.001). Moreover, prolactin was found negatively correlated with FMD (r = -0.576, P < 0.0001), and positively correlated with mean carotid IMT (r = 0.652, P < 0.0001). Multivariate regression analysis revealed that prolactin determined, independent of traditional risk factors, FMD (B = -0.589, 95% confidence interval (CI) -2.525 to -0.804, P = 0.001) and mean carotid IMT (B = 0.527, 95% CI 0.027-0.069, P < 0.0001). Hyperprolactinemia may be involved in the preclinical increase in carotid IMT, directly or by promoting atherogenic factors, including

  18. 视网膜动脉硬化与颈动脉内膜中层厚度相关性的分析%Analysis of retinal artery atherosclerosis and carotid artery intima-media thickness correlation

    Institute of Scientific and Technical Information of China (English)

    萨其热; 佟艳秋(通讯作者); 赵全良

    2014-01-01

    With the improvement of living standards of our people and changes in diet , atherosclerosis tends to increase , which is char-acterized by intimal involvement began , more performance for the eye retina arteriosclerosis .This paper analyzes the relationship and relat-ed factors between retinal arteriosclerosis with IMT .The results show that a growing number of retinal artery atherosclerosis with carotid in -timal thickening , IMT and retinal arteriosclerosis is a mutual influence , mutual causal relationship in diabetics .Carotid stenosis , especial-ly the internal carotid artery stenosis can directly affect the retinal blood supply .Therefore , early diagnosis helps to evaluate the situation whole body atherosclerosis .For coronary heart disease , hypertension , cerebrovascular accident and CRAO patients and high -risk groups play a good warning , delaying disease progression .%随着我国人民生活水平的提高和饮食习惯的改变,动脉硬化呈增高趋势,其特点是受累病变的内膜开始,眼部多表现为视网膜动脉硬化。本文对视网膜动脉硬化与IMT相关性及相关因素进行观察分析。结果表明,越来越多的视网膜动脉粥样硬化合并颈动脉内膜增厚,糖尿病患者IMT与视网膜动脉硬化是相互影响,互为因果的关系。颈动脉狭窄特别是颈内动脉狭窄可直接影响视网膜血供。因此,早期诊断有助于判定全身动脉硬化情况,对冠心病、高血压、脑血管意外以及CRAO等患者及高危人群起到良好的警示作用,延缓疾病的进展。

  19. Impact of carotid intima-media thickness on long-term outcome in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Munna Lal Patel

    2015-01-01

    Full Text Available Background: Chronic kidney disease (CKD patients on hemodialysis are highly prone to cardiovascular disease, which accounts for roughly half of the mortality in these patients. Atherosclerosis begins many years before the development of clinical manifestations. Measurement of carotid intima-media thickness (CIMT is a noninvasive procedure to detect early atherosclerotic changes. Aims: The aim of the study was to evaluate the correlation between CIMT and cardiovascular risk factors and to investigate its prognostic significance in CKD patients on hemodialysis. Materials and Methods: This was a prospective study carried out over a period of 18 months. Total 88 patients on hemodialysis and 50 healthy controls were enrolled in the study. Biochemical assay and CIMT was assessed using the high resolution 7.5 MHz sonography technique in all subjects. Results: Significant positive correlation was found with age, blood urea, serum creatinine, serum triglyceride, low-density lipoprotein, serum phosphorus, serum calcium-phosphorus product, serum uric acid, 24 h urine protein, systolic blood pressure, diastolic blood pressure, and body mass index. Negative correlation was found with estimated glomerular filtration rate. Adjusted hazards ratios of all cause and cardiovascular mortality for an increase of 0.1 mm in CIMT was 1.16 (95% confidence interval 0.15-9.09. Patients with CIMT value 0.97 mm had a renal survival rate of 16.5%. Conclusion: Uremia is an additive risk factors in those subjects who have raised CIMT despite of traditional cardiovascular risk factors.

  20. Mannose-Binding Lectin Levels and Carotid Intima-Media Thickness in Type 2 Diabetic Patients

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    Miklós Káplár

    2016-01-01

    Full Text Available Introduction. Mannose-binding lectin (MBL activates complement system and has been suggested to play a role in vascular complications in diabetics. Carotid intima-media thickness (cIMT detects subclinical atherosclerosis. We evaluated the association of MBL and IMT in type 2 diabetic (T2DM patients. Methods. Serum MBL levels and cIMT were measured in a total of 103 diabetics and in 98 age-matched healthy controls. Results. There was no significant difference in MBL level in T2DM versus controls. As expected, IMT was significantly higher in T2DM patients than in controls (P=0.001. In T2DM, the lowest cIMT was seen in patients with normal MBL level (500–1000 while cIMT continuously increased with both high MBL and absolute MBL deficiency states. This was especially significant in high MBL versus normal MBL T2DM patients (P=0.002. According to multiple regression analysis the main predictors of IMT in T2DM are age (P<0.003, ApoA level (P=0.023, and the MBL (P=0.036. Conclusions. Our results suggest a dual role of MBL as a risk factor for cIMT in T2DM. MBL may also be used as a marker of macrovascular disease, as both low and high levels indicate the susceptibility for atherosclerosis in T2DM.

  1. Rate of change of carotid intima-media thickness with magnesium administration in Abcc6⁻/⁻ mice.

    Science.gov (United States)

    Kupetsky, Erine A; Rincon, Fred; Uitto, Jouni

    2013-12-01

    Pseudoxanthoma elasticum (PXE), caused by mutations in the ABCC6 gene, demonstrates progressive build-up of calcium phosphate and proteoglycans in the skin, eye, and arteries, and is associated to myocardial infarctions, stroke, blindness, and elevated carotid intima-media thickness (CIMT). Although CIMT reduction with magnesium (Mg) has been documented in a mouse model for PXE (Abcc6(-/-) ), it is not clear if Mg is effective in humans with PXE to reduce CIMT. To examine this, we calculated the rate of change of CIMT (washout) in 15- and 12-month-old Abcc6(-/-) mice fed standard rodent diet with or without Mg supplementation for 2 months. Using means in untreated 15- and 12-month-old Abcc6(-/-) mice (145 and 120 μm, respectively), the rate of change was 8.3 μm/month. Using means in treated 15- and 12-month-old Abcc6(-/-) mice (118 and 104.6 μm, respectively), the rate of change was 4.5 μm. Compared to normal progression of CIMT in humans without PXE, PXE has advanced atherosclerosis and possibly a higher CIMT rate of change. This experiment may portend, at least in PXE, the rationale for a 1-year oral Mg CIMT clinical trial and may be useful for application in other progressive mineralizing disorders like atherosclerosis.

  2. Vitamin D, carotid intima-media thickness and bone structure in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Winckler, Karoline; Tarnow, Lise; Lundby-Christensen, Louise;

    2015-01-01

    with osteoporosis. A 25(OH)D level was not associated with carotid IMT or arterial stiffness (P>0.3) or bone health (P>0.6) after adjustment for CVD risk factors. In conclusion, 25(OH)D status was not associated with carotid IMT, arterial stiffness or bone health in this cohort of patients with T2D. To explore...

  3. Relationship of carotid intima-media thickness and duration of vegetarian diet in Chinese male vegetarians

    Directory of Open Access Journals (Sweden)

    Liu Chang-Qin

    2011-09-01

    Full Text Available Abstract Objective Many studies have shown that vegetarian diet has beneficial effects on the prevention of cardiovascular diseases. However, the effect of vegetarian diet on carotid intima-media thickness (IMT, as well as the association between IMT and duration of vegetarian diet, are still unclear. The present study aims to investigate the influence of duration of vegetarian diet on cardiovascular risk factors, and more importantly on IMT among Chinese vegetarians. Methods One hundred and seventy-one Chinese male vegetarians were screened for metabolic profile, cardiovascular risk and carotid IMT. They were compared with 129 age-matched omnivores recruited from a community-based health project. The effects of confounding factors were adjusted by stepwise logistic regression analysis. Results Compared to the omnivores, the vegetarians had lower BMI, weight, systolic blood pressure and diastolic blood pressure. Also, the levels of triglyceride, total cholesterol, HDL-Cholesterol, LDL-Cholesterol, ApoA1, ApoB, uric acid, albumin and γ-glutamyltransferase were significantly reduced in vegetarians. Omnivores had significantly higher fasting blood glucose than that of vegetarians. However, there were no differences in fasting insulin, C-reactive protein and HOMA-IR between the two groups. IMT was thinner in the vegetarian group than in the omnivore group (0.59 ± 0.16 vs. 0.63 ± 0.10 cm, P 11 years, those in tertile 1 ( Conclusion A decrease in multiple cardiovascular risk factors such as BMI, blood pressure and lipid profile was associated with vegetarian diet. Moreover, taking a low-calorie, low-protein, or vegetarian diet might have great beneficial effects on IMT through improved lipid profile, and the beneficial effects appeared to be correlated with the duration of vegetarian diet.

  4. Chronic Mild Hyperglycemia in GCK-MODY Patients Does Not Increase Carotid Intima-Media Thickness

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    Stepanka Pruhova

    2013-01-01

    Full Text Available Aim. GCK-MODY is an autosomal dominant form of diabetes caused by heterozygous mutations in the glucokinase gene leading to a lifelong mild hyperglycemia. The risk of macrovascular complications is considered low, but studies are limited. We, therefore, investigated the carotid intima-media thickness (CIMT as an indicator of macrovascular complications in a group of patients with GCK-MODY. Methods. Twenty-seven GCK mutation carriers and 24 controls recruited among their first-degree relatives were compared, all aging over 35 years. The CIMT was tested using a high-resolution B-mode carotid ultrasonography. Medical history, anthropometry, and biochemical blood workup were obtained. Results. The mean CIMT was 0.707 ± 0.215 mm (mean ± SD in GCK mutation carriers and 0.690 ± 0.180 mm in control individuals. When adjusted for age, gender, and family status, the estimated mean difference in CIMT between the two groups increased to 0.049 mm (P=0.19. No difference was detected for other characteristics, with the exception of fasting blood glucose (GCK-MODY 7.6 mmol/L ± 1.2 (136.4 mg/dL; controls 5.3 mmol/L ± 0.3 (95.4 mg/dL; P<0.0001 and glycated hemoglobin HbA1c (GCK-MODY 6.9% ± 1.0%, 52 mmol/mol ± 10; controls 5.7% ± 0.4%, 39 mmol/mol ± 3; P<0.0001. The frequency of myocardial infarction and ischemic stroke did not differ between groups. Conclusion. Our data indicate that the persistent hyperglycemia in GCK-MODY is associated with a low risk of developing diabetic macrovascular complications.

  5. Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study

    Science.gov (United States)

    Wang, Xin; den Ruijter, Hester M.; Anderson, Todd J.; Britton, Annie R.; Dekker, Jacqueline; Engström, Gunnar; Evans, Greg W.; de Graaf, Jacqueline; Grobbee, Diederick E.; Hedblad, Bo; Holewijn, Suzanne; Ikeda, Ai; Kauhanen, Jussi; Kitagawa, Kazuo; Kitamura, Akihiko; Kurl, Sudhir; Lonn, Eva M.; Lorenz, Matthias W.; Mathiesen, Ellisiv B.; Nijpels, Giel; Okazaki, Shuhei; Polak, Joseph F.; Price, Jacqueline F.; Rembold, Christopher M.; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T.; Sitzer, Matthias; Stehouwer, Coen D. A.; Tuomainen, Tomi-Pekka; Peters, Sanne A. E.; Bots, Michiel L.

    2017-01-01

    Background The relation of a single risk factor with atherosclerosis is established. Clinically we know of risk factor clustering within individuals. Yet, studies into the magnitude of the relation of risk factor clusters with atherosclerosis are limited. Here, we assessed that relation. Methods Individual participant data from 14 cohorts, involving 59,025 individuals were used in this cross-sectional analysis. We made 15 clusters of four risk factors (current smoking, overweight, elevated blood pressure, elevated total cholesterol). Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) between clusters using those without any of the four risk factors as reference group. Results Compared to the reference, those with 1, 2, 3 or 4 risk factors had a significantly higher common CIMT: mean difference of 0.026 mm, 0.052 mm, 0.074 mm and 0.114 mm, respectively. These findings were the same in men and in women, and across ethnic groups. Within each risk factor cluster (1, 2, 3 risk factors), groups with elevated blood pressure had the largest CIMT and those with elevated cholesterol the lowest CIMT, a pattern similar for men and women. Conclusion Clusters of risk factors relate to increased common CIMT in a graded manner, similar in men, women and across race-ethnic groups. Some clusters seemed more atherogenic than others. Our findings support the notion that cardiovascular prevention should focus on sets of risk factors rather than individual levels alone, but may prioritize within clusters. PMID:28323823

  6. Carotid Intima Media Thickness in the Astronaut Corps: Association to Spacecraft

    Science.gov (United States)

    Suffredini, John; Locke, James; Johnston, Smith; Charvat, Jacqueline; Young, Millennia; Garcia, Kathleen; Sargsyan, Ashot E.; Tarver, William

    2017-01-01

    Background: Carotid Intima Media Thickness (CIMT) has been demonstrated to be predictive of future cardiovascular events. Within various populations, radiation exposure, stress, and physical confinement have all been linked to an increased CIMT. Recent research discovered CIMT was significantly increased in ten long duration astronauts from pre-flight to four days post flight. The relationship between spaceflight and CIMT is not understood and trends in CIMT within the larger astronaut population are unknown. Methods: In 2010, CIMT was offered as part of the astronaut annual exam at the JSC Flight Medicine Clinic using a standardized CIMT screening protocol and professional sonographers. Between 2010 and 2016, CIMT measurements were collected on 213 NASA astronauts and payload specialists. The values used in this retrospective chart review are the mean of the CIMT from the right and left. Spaceflight exposure was categorized based on the total number of days spent in space at the time of the ground-based ultrasound (0, 1-29, 30-100, 101-200, =200). Linear regression with generalized estimating equations were used to estimate the association between spaceflight exposures and CIMT. Results: 530 studies were completed among 213 astronauts with a mean of 2.5 studies (range 1-6) per astronaut over the six year period. As in other populations, CIMT was significantly associated with age; however, gender was not. While there was no significant direct correlation between total spaceflight exposure and CIMT found, astronauts with 30-100 spaceflight days and astronauts with greater than 100 spaceflight days had significantly increased CIMT over astronauts who had never flown (p=0.002 and p=<0.0001 respectively) after adjustment for age. Conclusion: Further work is needed to fully understand CIMT and its association to spaceflight. Current occupational surveillance activities are under way to study CIMT values in conjunction with other cardiovascular risk factors among

  7. Bariatric surgery decreases carotid intima-media thickness in obese subjects

    Directory of Open Access Journals (Sweden)

    Gonzalo García

    2013-08-01

    Full Text Available Background: Obesity has long been associated with an increased risk of cardiovascular disease (CVD. The aim of this study was to evaluate the impact of substantial weight loss induced by bariatric surgery on carotid intima media thickness (C-IMT (surrogate marker of early atherosclerosis and classic factors of cardiovascular risk (CVRFs. Methods: thirty-one obesity patients were evaluated for bariatric surgery. Twenty-seven were undergone surgery, 14 Roux-en-Y gastric bypass surgery (GBS and 13 sleeve gastrectomy. The four obese patients who did not undergo surgery, were performed the same evaluations. Measurements: Body weight, BMI, blood pressure, total cholesterol, TC levels, LDL-C, HDL-C, TG, fasting plasma glucose and insulin, HOMA IR, and US B-mode C-IMT was measured. Results: After 354 ± 92 days follow up, 27 patients that underwent bariatric surgery evidenced a mean body mass index decrease from 38 to 27 k/m² (p < 0.001, simultaneously was observed improvement in CVRFs, 10 years Framingham risk and a significant reduction of therapeutic requirements. C-IMT diminished from a mean of 0.58 ± 0.14 mm to 0.49 ± 0.09 mm (p = 0.0001. Four patients that did not undergo surgery increased C-IMT from 0.52 ± 0.12 to 0.58 ± 0.13 mm (p = 0.03 with no significant changes in CVRFs. Conclusion: Weight loss, one year after bariatric surgery, GBS and sleeve gastrectomy, decreases C-IMT; improve CVRFs and 10 years Framingham risk.

  8. Arsenic exposure from drinking water, arsenic methylation capacity, and carotid intima-media thickness in Bangladesh.

    Science.gov (United States)

    Chen, Yu; Wu, Fen; Graziano, Joseph H; Parvez, Faruque; Liu, Mengling; Paul, Rina Rani; Shaheen, Ishrat; Sarwar, Golam; Ahmed, Alauddin; Islam, Tariqul; Slavkovich, Vesna; Rundek, Tatjana; Demmer, Ryan T; Desvarieux, Moise; Ahsan, Habibul

    2013-08-01

    We conducted a cross-sectional study to evaluate the interrelationships between past arsenic exposure, biomarkers specific for susceptibility to arsenic exposure, and carotid intima-media thickness (cIMT) in 959 subjects from the Health Effects of Arsenic Longitudinal Study in Bangladesh. We measured cIMT levels on average 7.2 years after baseline during 2010-2011. Arsenic exposure was measured in well water at baseline and in urine samples collected at baseline and during follow-up. Every 1-standard-deviation increase in urinary arsenic (357.9 µg/g creatinine) and well-water arsenic (102.0 µg/L) concentration was related to a 11.7-µm (95% confidence interval (CI): 1.8, 21.6) and 5.1-µm (95% CI: -0.2, 10.3) increase in cIMT, respectively. For every 10% increase in monomethylarsonic acid (MMA) percentage, there was an increase of 12.1 µm (95% CI: 0.4, 23.8) in cIMT. Among participants with a higher urinary MMA percentage, a higher ratio of urinary MMA to inorganic arsenic, and a lower ratio of dimethylarsinic acid to MMA, the association between well-water arsenic and cIMT was stronger. The findings indicate an effect of past long-term arsenic exposure on cIMT, which may be potentiated by suboptimal or incomplete arsenic methylation capacity. Future prospective studies are needed to confirm the association between arsenic methylation capacity and atherosclerosis-related outcomes.

  9. 应用冠状动脉钙化积分诊断老年人冠心病的研究%Clinical study on coronary artery calcification score combined with carotid intima-media thickness measure in elderly patients with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    林萍; 谢晓林; 胡芸

    2009-01-01

    Objective To evaluate the clinical diagnostic value of coronary artery calcification score(CACS)of multi-slice spiral computed tomography(MSCT)combined with carotid intima-media thickness(IMT)measure in elderly patients with coronary artery disease(CAD). Methods CACS of MSCT,carotid IMT measure,and coronary angiography were performed in 68 patients,including 36 cases with CAD(CAD group)diagnosed by coronary angiography and 32 cases(control group)with coronary arterial stenosis(<50% stenosis).CACS and carotid IMT were compared between two groups. Results The coronary artery calcification score was significantly increased in CAD group compared with the control group[(349.5±86.3)vs.(74.7±25.2),t=13.670,P<0.01],and it was increased with the severity of coronary arterial stenosis.The carotid intima-media thickness in CAD group showed significant difference with that in control group[(1.11±0.05)mm vs(0.69±0.13)mm,t=13.587,P<0.01].In CAD group,CACS exhibited a significant positive correlation with carotid IMT(r=0.950,P<0.01).The positive rates of CACS and carotid IMT were both 77.8% (28 cases)in CAD group and both 12.5%(4 cases)in control group,which showed significant difference between two groups(X2=28.976,P<0.01). Conclusions CACS of MSCT combined with carotid IMT have high sensitivity and specificity in evaluating coronary arteriaI stenosis.It can be used as a non-invasive examination to diagnose CAD in the elderly.%目的 探讨多层螺旋CT冠状动脉钙化积分(CACS)结合测量颈动脉内膜-中膜厚度(IMT)在老年人冠心病诊断中的价值. 方法 68例患者均行多层螺旋CT测定CACS、测量颈动脉IMT及冠状动脉造影检查,冠心病组36例患者行冠状动脉造影诊断为冠心病;非冠心病组32例,为冠状动脉造影证实冠状动脉狭窄<50%者.比较冠心病组与非冠心病组CACS值及颈动脉IMT.结果冠心病组CACS较非冠心病组明显升高[分别为(349.5±86.3)分和(74.7±25.2)分,t=13

  10. No association of atherosclerosis with digital ulcers in Japanese patients with systemic sclerosis: evaluation of carotid intima-media thickness and plaque characteristics.

    Science.gov (United States)

    Motegi, Sei-Ichiro; Toki, Sayaka; Hattori, Tomoyasu; Yamada, Kazuya; Uchiyama, Akihiko; Ishikawa, Osamu

    2014-07-01

    Patients with systemic sclerosis (SSc) usually develop Raynaud's phenomenon, persistent digital ischemia and sometimes develop digital ulcers (DU). Several studies have reported an association of carotid artery atherosclerosis with SSc by evaluating carotid intima-media thickness (IMT) in SSc patients. However, none of those studies analyzed the association between DU and carotid artery atherosclerosis in SSc patients. We examined the association of carotid artery atherosclerosis with digital ulcers by comparing SSc patients with (n = 48, 29.5%) and without (n = 206, 70.5%) DU. The demographic and clinical features of the SSc patients showed that young age, male sex, anti-topoisomerase I antibody positivity, severe skin sclerosis, interstitial lung disease complication and cardiac involvements were significantly prevalent in patients with DU. In addition, diffuse cutaneous type, anti-RNA polymerase III antibody positivity and severe skin sclerosis are more frequent in SSc patients with DU at the extensor surface of joints than SSc patients with DU at the digital tip. There were no differences in serum lipid level, carotid IMT or plaque score between SSc patients with and without DU, suggesting that atherosclerotic changes are not primarily involved in the development of DU.

  11. Study of the Relationship between Carotid Intima-media Thickness and Traditional Chinese Medicine Syndrome of Dyslipidemia

    Institute of Scientific and Technical Information of China (English)

    雷燕; 王振华; 赵浩; 刘剑刚

    2009-01-01

    Objective:The study aimed to explore the relationship between the carotid intima-media thickness (IMT),lipids,high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy) and other indices of laboratory and the traditional Chinese medicine(TCM) syndrome of dyslipidemia.Methods:A total of 152 dyslipidemia patients and 8 healthy people(taken as the control group) were recruited.According to the theory of the TCM syndrome,152 dyslipidemia patients were assigned to 4 groups:the stagnation of phlegm(SP) grou...

  12. 脑梗死患者颈动脉内膜-中膜厚度与LDL、OX-LDL关系的研究%Study on intima-media thickness of carotid artery and relation between it and LDL or OX-LDL

    Institute of Scientific and Technical Information of China (English)

    毛善英; 刘建仁; 黄鉴政; 吴敏良; 毛显雅; 魏芳; 刘学明

    2001-01-01

    Objective To explore the level of artherosclerosis in carotid artery of cerebral infarction patients, analyse the relation between artherosclerosis and serum LDL,OX-LDL. Methods Determine the intima-media thickness(IMT) of carotid artery in cerebral infarction patiens and control. Measure low density lipoprotein(LDL) and oxided low density lipoprotein(OX-LDL) in their serum, Compare IMT and serum LDL,OX-LDL in cerebral infarction patients groups. Analyse the correlation between IMT and serum LDL,OX-LDL. Result IMT in the group of cerebral infarction accompanied diabetes was higher than the other groups . IMT was significantly positively correlated with LDL,OX-LDL. Conclusion Patients with cerebral infarction, especially those acompanied with diabetes have more severe artherosclerosis change in carotid artery. LDL,OX-LDL are crucial factors that could expedite artherosclerosis of carotid artery.%目的 研究脑梗死患者颈动脉粥样硬化的程度, 分析低密度脂蛋白(LDL)、氧化低密度脂蛋白(OX-LDL)与颈动脉粥样硬化的关系。方法 B超测定脑梗死组及对照组的颈动脉内膜-中膜厚度(intimal-media thickness;IMT)。测定受试者的LDL、OX-LDL。比较各脑梗死组及对照组的IMT和LDL、OX-LDL。对IMT和LDL、OX-LDL相关分析。结果 伴糖尿病的脑梗死组IMT高于其它脑梗死组及对照组。IMT与LDL、OX-LDL显著正相关。结论 脑梗死患者的颈动脉粥样硬化程度显著高于对照组; 其中伴有糖尿病的脑梗死患者的颈动脉粥样硬化程度尤为明显, LDL、OX-LDL是促进颈动脉粥样硬化的关键因子。

  13. Association of Microalbuminuria and Estimated Glomerular Filtration Rate With Carotid Intima-Media Thickness in Patients With Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Dehdashti Shahrokh

    2015-04-01

    Full Text Available Background Atherosclerosis is the main cause of cardiovascular diseases, and its risk enhances in type 2 diabetes mellitus. Objectives This study aimed to evaluate Carotid Intima-Media Thickness (CIMT by carotid artery ultrasonography and assess its correlation with microalbuminuria and estimated Glomerular Filtration Rate (eGFR in the patients with type 2 diabetes mellitus. Patients and Methods This cross-sectional study was included 205 patients with Type 2 Diabetes Mellitus (T2DM. We recorded clinical and biochemical data such as FBS, lipid profile, and urinary albumin. Intima-media thickness of carotid arteries was measured in all patients by high frequency ultrasound. Results In simple correlation coefficients analysis, CIMT was significantly associated with total cholesterol (r = 0.197, P = 0.008, serum creatinine (r = 0.240, P = 0.001, and urinary albumin (r = 0.420, P = 0.000. Also, CIMT elevated significantly with the stage progression of chronic kidney disease (0.67 ± 0.15 mm in stage 1, 0.73 ± 0.22 mm in stage 2, and 0.82 ± 0.21 mm in stage 3 (P value = 0.024. In multivariate linear regression analysis, the duration of diabetes, weight, HDL, serum creatinine, urinary albumin, and estimated Glomerular Filtration Rate (eGFR were independently associated with CIMT (P value < 0.05 for all. Conclusions Our study shows a relationship between CIMT and renal parameters, including eGFR and albuminuria. This study confirms the importance of intensive examinations for early detection of atherosclerosis and treatment of risk factors.

  14. Effects of active and passive smoking on the development of cardiovascular disease as assessed by a carotid intima-media thickness examination in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Jiang, Fei; Wang, Jie; Zhang, Rong; Chen, Miao; Peng, Danfeng; Sun, Xue; Yan, Jing; Luo, Yi; Tang, Shanshan; Hu, Cheng; Jia, Weiping

    2015-05-01

    Carotid intima-media thickness has been widely used as a surrogate end-point for cardiovascular disease, myocardial infarction, and stroke. This study aimed to assess the effects of active and passive smoking exposure on the development of cardiovascular disease in patients with type 2 diabetes mellitus. Seven hundred twenty-two patients with type 2 diabetes mellitus were recruited for the study. A standardized questionnaire on smoking status, pack-years of smoking, and the number of years of smoking cessation was provided to the patients, and their responses were collected for analysis. The carotid intima-media thickness, carotid plaque, and the internal diameter of the common carotid artery were determined by high-resolution B-mode ultrasonography. Compared to non-smokers, passive female smokers had a higher risk of cardiovascular disease (odds ratio = 3.50, 95% confidence interval: 1.29-9.49, P = 0.009); they also had a significantly larger common carotid artery (P = 0.041) and risk of carotid plaque (odds ratio = 2.20, 95% confidence interval: 1.1980-4.0505, P = 0.01). Both active and passive male smokers had a significantly greater carotid intima-media thickness than non-smokers (P = 0.003 and P = 0.005, respectively). Male active smokers had a significantly higher risk of carotid plaque (odds ratio = 2.88, 95% confidence interval: 1.4788-5.6094, P = 0.001). In conclusion, cumulative active and passive smoking exposures are significant risk factors for carotid atherosclerosis in patients with type 2 diabetes mellitus. Our results highlight the importance of endorsing a smoke-free environment for patients with type 2 diabetes mellitus.

  15. Atherosclerosis is Associated Comorbidity in Patients with Chronic Obstructive Pulmonary Disease: Ultrasound Assessment of Carotid Intima Media Thickness

    Directory of Open Access Journals (Sweden)

    Manal R. Hafez

    2016-12-01

    Full Text Available Objective: To assess atherosclerotic comorbidity in chronic obstructive pulmonary disease (COPD patients and its relationship to COPD severity, hypoxemia, and hypercapnia. Methods: A hospital-based observational case-control study was conducted on 86 male COPD patients, and 86 age-matched healthy subjects (non-COPD group. Carotid intima-media thickness (CIMT was assessed by Doppler ultrasound; in addition, spirometry and arterial blood gas tests were done. Results: CIMT was significantly increased in the COPD group compared to the non-COPD group (0.84±0.15 vs. 0.63±0.076, p<0.001. When the CIMT value of ≥0.8 mm was defined as a cutoff value for a thickened CIMT complex, 64% of COPD patients versus 8.1% of non-COPD subjects had a thickened CIMT. COPD patients with a thickened CIMT were older and had a higher PaCO2, lower FEV1%, FVC, and FEF25–75% compared to COPD patients with a normal CIMT. Thickened CIMT in COPD patients was significantly associated with hypoxemia (p=0.008, OR=8.2, hypercapnia (p=0.04, OR=6.2, and airflow limitation (p=0.11, OR=2.1. There was no significant difference in CIMT in relation to COPD severity (p=0.83. Conclusion: Atherosclerosis is prevalent in COPD patients, even in the early stages of the disease. Hypoxemia, hypercapnia, and airflow limitation are risk factors of atherosclerosis in COPD patients.

  16. Interaction between arsenic exposure from drinking water and genetic susceptibility in carotid intima-media thickness in Bangladesh.

    Science.gov (United States)

    Wu, Fen; Jasmine, Farzana; Kibriya, Muhammad G; Liu, Mengling; Cheng, Xin; Parvez, Faruque; Paul-Brutus, Rachelle; Paul, Rina Rani; Sarwar, Golam; Ahmed, Alauddin; Jiang, Jieying; Islam, Tariqul; Slavkovich, Vesna; Rundek, Tatjana; Demmer, Ryan T; Desvarieux, Moise; Ahsan, Habibul; Chen, Yu

    2014-05-01

    Epidemiologic studies that evaluated genetic susceptibility for the effects of arsenic exposure from drinking water on subclinical atherosclerosis are limited. We conducted a cross-sectional study of 1078 participants randomly selected from the Health Effects of Arsenic Longitudinal Study in Bangladesh to evaluate whether the association between arsenic exposure and carotid artery intima-media thickness (cIMT) differs by 207 single-nucleotide polymorphisms (SNPs) in 18 genes related to arsenic metabolism, oxidative stress, inflammation, and endothelial dysfunction. Although not statistically significant after correcting for multiple testing, nine SNPs in APOE, AS3MT, PNP, and TNF genes had a nominally statistically significant interaction with well-water arsenic in cIMT. For instance, the joint presence of a higher level of well-water arsenic (≥ 40.4 μg/L) and the GG genotype of AS3MT rs3740392 was associated with a difference of 40.9 μm (95% CI = 14.4, 67.5) in cIMT, much greater than the difference of cIMT associated with the genotype alone (β = -5.1 μm, 95% CI = -31.6, 21.3) or arsenic exposure alone (β = 7.2 μm, 95% CI = -3.1, 17.5). The pattern and magnitude of the interactions were similar when urinary arsenic was used as the exposure variable. Additionally, the at-risk genotypes of the AS3MT SNPs were positively related to the proportion of monomethylarsonic acid (MMA) in urine, which is indicative of arsenic methylation capacity. The findings provide novel evidence that genetic variants related to arsenic metabolism may play an important role in arsenic-induced subclinical atherosclerosis. Future replication studies in diverse populations are needed to confirm the findings.

  17. CAROTID INTIMA-MEDIA THICKNESS AND THE ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS IN THE ELDERLY

    Institute of Scientific and Technical Information of China (English)

    叶平; 王节; 尚延忠; 朱平

    2001-01-01

    Objective. To investigate the association of carotid arterial intima media thickness (IMT) with principal cardiovascular risk factors in the elderly. Methods. Carotid arterial IMT was measured by high resolution B mode ultrasound in 94 elderly subjects (old aged group), and compared with subjects aged < 60 (middle-aged group). Results. In comparison with the middle-aged group, the prevalence of coronary heart disease, cerebral vascular disease, hypertension and diabetes mellitus was significantly higher, and serum cholesterol and systolic blood pressure were also significantly higher in old aged group. Although there was no obvious difference in IMT between the two groups, carotid plaque and carotid wall thickening were more frequently found in old aged group. Age, systolic blood pressure and serum cholesterol were shown as the independent determinants for carotid IMT in the total participants, whereas no such independent relation was found in old-aged group. Conclusion. Age is the major risk factor for carotid atherosclerosis in the elderly. In other words, the occurrence of carotid atherosclerosis is the result of advancing age combined with the effect of multiple cardiovascular risk factors.

  18. Carotid intima-media thickness is reduced 12 months after gastric bypass surgery in obese patients with type 2 diabetes or impaired glucose tolerance

    DEFF Research Database (Denmark)

    Lundby-Christensen, Louise; Tarnow, Lise; Hansen, Dorte L

    2014-01-01

    AIM: To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: Observati......AIM: To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS...

  19. Association Between IL-18 and Carotid Intima-Media Thickness in Patients with Type II Diabetic Nephropathy

    Science.gov (United States)

    Zhang, Yuanyuan; Feng, Haomiao; Wei, Zhiyong

    2017-01-01

    Background We specifically designed this study to determine the relationship between levels of IL-8 and carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM). Material/Methods A total of 149 diabetic patients at different stages of diabetic nephropathy and 72 matched controls were recruited in this study. A wide range of parameters were measured: IL-18 (by ELISA), urinary albumin excretion rates (UAER), and carotid intima-media thickness (cIMT, by pulse wave velocity [PWV]). All the diabetic patients were treated by alprostadil. Results ELISA indicated that the level of IL-18 in the patient group was significantly higher compared with that in the control group. The level of IL-18 apparently increased in the higher cIMT group in T2DM patients. Serum IL-18 levels were positively correlated with cIMT in patients with T2DM, the level of IL-18 was negatively correlated with cIMT, and IL-18 levels were positively correlated to age. Moreover, IMT was positively correlated with hemoglobin A1C (HbA1C) and IL-18 levels were significantly associated with cIMT (all P<0.05). Conclusions IL-18 levels were positively correlated with atherosclerotic burden in patients with T2DM and it may be considered as a significant therapeutic target. PMID:28125566

  20. 冠心病患者颈动脉内膜-中层厚度及微量白蛋白尿与冠状动脉病变的关系%Relationship of the carotid intima-media thickness and microalbuminuria with the severity of coronary artery lesions to the coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    涂昌; 潘伟彪; 兰军; 陈本发; 叶文卫

    2013-01-01

    Objective To investigate the relationship of the carotid intima-media thickness and microalbuminuria with the severity of coronary artery lesions to the coronary heart disease. Methods 82 patients treated with coronary arteriography in our hospital from October 2009 to November 2011 were selected and divided into coronary artery imaging normal group (n=24), single-vessel disease group (n=22), double -vessel disease group (n=16) and three-multivessel disease group (n=20). Gensini method was used to calculate the integral of coronary artery lesion degree; carotid artery sonography were applied before and 1 week after the coronary arteriography, bilateral carotid IMT and plaque situation were checked up: microalbuminuria value was measured, the relationship of the carotid IMT and microalbuminuria with the severity of coronary artery lesions were analyzed. Results IMT of single-vessel disease group, double -vessel disease group and three-multivessel disease group were all higher than those of coronary artery imaging normal group; carotid TMT, plaque occurrence rate, plaque integral and microalbuminuria were all found increased followed the severity of the coronary artery lesion, the differences were all statistically significant (all P < 0.05). Positive relationship was found between the microalbuminuria and Gensin-S (r=0.54,P < 0.05), positive relationship was found between the microalbuminuria and IMT (r = 0.57,P < 0.05). Conclusion Carotid TMT and microalbuminuria can predict the severity of coronary artery lesions and have important clinical significant of evaluate the coronary heart disease.%目的 探讨冠心病患者冠状动脉病变程度与颈动脉内膜-中层厚度(IMT)及尿微量白蛋白(MAU)的相关性.方法 选择2009年10月~2011年11月我院行冠状动脉造影者82例,根据血管病变程度分为冠状动脉造影正常组(n = 24)、单支病变组(n = 22)、双支病变组(n = 16)、三支及多支病变组(n = 20),Gensini法计算

  1. Dialysis methods may affect carotid intima-media thickness in Chinese end-stage renal disease patients.

    Science.gov (United States)

    Shi, Zhanqin; Zhu, Ming; Guan, Jianming; Chen, Jianghua; He, Qiang; Zhang, Xiaohui; Zhu, Shaoming; Song, Xuequan; Wang, Xiaoyi; Jiang, Zhiqiang

    2012-01-01

    Atherosclerosis is the most common cause of cardiovascular morbidity in end-stage renal disease (ESRD) patients and carotid intima-media thickness (IMT) is an early independent predictor of atherosclerosis. The aim of this study is to compare the continuous ambulatory peritoneal dialysis (CAPD) and the maintenance hemodialysis (MHD) for carotid IMT in Chinese ESRD patients. A total of 72 CAPD patients, 92 MHD patients, and 50 age- and sex-matched healthy controls were included. Dialysis patients were divided into five subgroups according to dialysis duration: 3-6, 7-12, 13-59, 60-119, and 120-179 months. Carotid IMT and carotid plaques were detected for each patient. The carotid IMT and total plaque detection rate in the CAPD and MHD groups were considerably higher than in the healthy control group (p  0.05). However, after stratification by dialysis duration, the total carotid IMT in the CAPD subgroup was higher than in the MHD subgroup in dialysis duration of 60-119 and 120-179 months (p  0.05). Our study showed that both CAPD and MHD affect carotid IMT in Chinese ESRD patients, and the degree of atherosclerosis in CAPD patients might be higher than that in MHD patients after 5 years of dialysis.

  2. The assessment of carotid intima media thickness and serum Paraoxonase-1 activity in Helicobacter pylori positive subjects

    Directory of Open Access Journals (Sweden)

    Akbas Halide S

    2010-08-01

    Full Text Available Abstract Background The role of inflammation in the pathogenesis and progression of atherosclerosis has been increasingly discussed. Although the seroepidemiological studies have suggested a relationship between Helicobacter pylori (H. pylori infection and atherosclerosis; the issue is still controversial. It is well known that abnormal lipid profil is related to atherosclerosis and the measurement of carotid-intima media thickness (CIMT is one of the surrogate marker of atherosclerosis. The serum concentration of high-density lipoprotein (HDL-C has been known to have an inverse correlation with the development of atherosclerosis. Paraoxonase-1 (PON1 is a major anti-atherosclerotic component of HDL-C. PON1 activity is related to lipid peroxidation and prospective cardiovascular risk. The aim of this study was to investigate CIMT and serum PON1 activities along with lipid parameters in H. pylori positive and negative subjects. Methods Thirty H. pylori positive subjects and thirty-one negative subjects were enrolled. H. pylori infection was diagnosed by the presence of positivity of stool H. pylori antigen test or Carbon 14 labeled urea breath test. Serum PON1 activity was measured spectrophotometrically. Traditional cardiovascular risk factors were investigated and laboratory analysis included measurement of serum triglycerides (TG, total cholesterol (TC, high-density lipoprotein (HDL-C and low-density lipoprotein cholesterol (LDL-C. We assessed CIMT by high-resolution ultrasound of both common carotid arteries. Results We found that the mean and maximum values of right and overall CIMT in H. pylori positive subjects were significantly thicker than those of H. pylori negative subjects. There was no significant differences in serum HDL-C, LDL-C, TC levels and TC/HDL-C ratios between two groups. Serum TG levels of H. pylori positive subjects were significantly higher than those of H. pylori negative subjects (p = 0.014. We found that PON1

  3. Metformin, arterial function, intima-media thickness and nitroxidation in metabolic syndrome: the mefisto study.

    Science.gov (United States)

    Meaney, Eduardo; Vela, Agustín; Samaniego, Virginia; Meaney, Alejandra; Asbún, Juan; Zempoalteca, Juan-Carlos; Elisa, Zárate N; Emma, Mendoza N; Guzman, Martin; Hicks, Juan; Ceballos, Guillermo

    2008-08-01

    1. Metabolic syndrome (MS) is one of the greatest public health problems in Mexico, where more than 75% of adults in urban populations are overweight or obese. Metabolic syndrome has several comorbidities, which result in a high cardiometabolic risk. 2. Some of the vasopathogenic phenomena in MS are caused by nitroxidant stress, secondary to cardiometabolic dysfunction. 3. The action of metformin to diminish or control MS remains a matter of debate. 4. In the present study, 60 patients with at least three diagnostic criteria for MS were divided into two groups. Both groups received similar dietary counselling, but one group was given 850 mg metformin daily. 5. The variables assessed were body mass index, waist circumference, systolic and diastolic blood pressures (SBP and DBP, respectively), total cholesterol (TC), high- and low-density lipoprotein-cholesterol, triglycerides (TG), fasting glucose, nitroxidant metabolites (free carbonyls, malondialdehyde, dityrosines and advanced oxidative protein products (AOPP)), nitric oxide (NO), carotid vascular stiffness, carotid intima-media thickness (IMT) and C-reactive protein (CRP). 6. After 1 year follow up, both groups reported weight loss, as well as decreases in waist circumference, SBP and DBP. 7. Patients on metformin exhibited reductions in TC and IMT and there were marked changes in nitroxidation: levels of carbonyls, dityrosines and AOPP were reduced, whereas those of NO were increased, indicating better endothelial function. In addition, in patients given metformin, CRP levels decreased. 8. In conclusion, metformin has a considerable beneficial effect on nitroxidation, endothelial function and IMT in patients with MS.

  4. Appropriateness of carotid plaque and intima-media thickness assessment in routine clinical practice

    Directory of Open Access Journals (Sweden)

    Alessi Alexandre

    2008-10-01

    Full Text Available Abstract Objectives To describe the findings and evaluate appropriateness of a carotid artery study including the measurement of IMT, the presence of atherosclerotic plaque, and their correlation with cardiovascular risk factors. Methods 555 patients (220 men; 67.06 ± 12.44 years were included in the study. 120 patients (21.62% presented carotid plaque: 108 (19.45% in patients with at least one risk factor and 12 (2.1% in patients without risk factors. With respect to appropriateness of the present studies: 65% were appropriate, 22% were uncertain and 13% were inappropriate. The IMT medians were higher in males (0.0280; 95% CI, 00.82 to 0.478; p = 0.0057 and in hypertensive patients (0.391; 95% CI, 0.0190 to 0.0592; p = 0,001. There was a linear increase in mean IMT for each year increased in age (0.0059; 95% CI; 0.0050 to 0.0067. Carotid plaque was more frequent in patients with CAD (p = 0.0002, diabetes (p = 0.024 and hypertension (p = 0.036. Conclusion Assessment of carotid arteries identified increased incidence of plaque in patients with CAD, diabetes and hypertension. IMT was increased in older patients, hypertensive patients and males. Forty-five percent of the patients were studied based on uncertain and inappropriate reasons.

  5. 血清游离脂肪酸水平与非酒精性脂肪性肝病及颈动脉内膜中层厚度的相关研究%Correlation of serum free fatty acid levels with non-alcoholic fatty liver disease and carotid artery intima-media thickness

    Institute of Scientific and Technical Information of China (English)

    郝齐志

    2014-01-01

    Objective To investigate the correlation of serum free fatty acids levels with non-alcoholic fatty liver disease (NAFLD) and carotid artery intima-media thickness (CIMT).Methods The blood lipid levels,insulin resistance and CIMT thickness were measured in 150 healthy controls and 168 cases of NAFLD.The independent factors influencing NAFLD,and CIMT were analyzed.Results The levels of fasting blood glucose,triglycerides,fasting insulin,fasting free fatty acids and CIMT thickness were significantly higher in patients with NAFLD than those in healthy controls(P < 0.01).Conclusions Free fatty acid levels are independent risk factors of NAFLD.NAFLD patients have elevated levels of serum free fatty acids.In addition,elevated serum free fatty acid levels are correlated with CIMT.%目的 探讨血清游离脂肪酸水平与非酒精性脂肪肝病(NAFLD)及颈动脉内膜中层厚度(CIMT)间的关系.方法 测定150例健康对照和168例NAFLD患者的血脂水平、胰岛素抵抗和CIMT厚度.分析影响NAFLD、CIMT的独立因素.结果 NAFLD组患者较健康对照组空腹血糖、三酰甘油、空腹胰岛素、空腹游离脂肪酸及CIMT等指标均显著升高(P<0.01).结论 游离脂肪酸水平是NAFLD患病的独立影响因素,NAFLD患者血清游离脂肪酸水平普遍升高,NAFLD患者血清游离脂肪酸水平升高与CIMT增加有关.

  6. Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque

    NARCIS (Netherlands)

    J.C. Bis (Joshua); M. Kavousi (Maryam); N. Franceschini (Nora); A.J. Isaacs (Aaron); G.R. Abecasis (Gonçalo); U. Schminke (Ulf); W.S. Post (Wendy S.); A.V. Smith (Albert Vernon); L.A. Cupples (Adrienne); H.S. Markus (Hugh S.); R. Schmidt (Reinhold); J.E. Huffman (Jennifer); T. Lehtimäki (Terho); J. Baumert (Jens); T. Münzel (Thomas); S.R. Heckbert (Susan); A. Dehghan (Abbas); K.E. North (Kari); B.A. Oostra (Ben); S. Bevan (Steve); E.M. Stoegerer (Eva Maria); C. Hayward (Caroline); O. Raitakari (Olli); C. Meisinger (Christa); A. Schillert (Arne); S. Sanna (Serena); H. Völzke (Henry); Y.C. Cheng (Yu Ching); B. Thorsson (Bolli); C.S. Fox (Caroline); K. Rice (Kenneth); F. Rivadeneira Ramirez (Fernando); V. Nambi (Vijay); E. Halperin (Eran); K. Petrovic (Katja); L. Peltonen (Leena Johanna); H.E. Wichmann (Heinz Erich); R.B. Schnabel (Renate); M. Dörr (Marcus); A. Parsa (Afshin); T. Aspelund (Thor); S. Demissie (Serkalem); S. Kathiresan (Sekar); M.P. Reilly (Muredach); K.D. Taylor (Kent); A.G. Uitterlinden (André); D.J. Couper (David); M. Sitzer (Matthias); M. Kähönen (Mika); T. Illig (Thomas); P.S. Wild (Philipp); M. Orrù (Marco); J. Lüdemann (Jan); A.R. Shuldiner (Alan); G. Eiriksdottir (Gudny); C.C. White (Charles); J.I. Rotter (Jerome); A. Hofman (Albert); J. Seissler (Jochen); T. Zeller (Tanja); G. Usala; F.D.J. Ernst (Florian); L.J. Launer (Lenore); R.B. D'Agostino (Ralph); D.H. O'Leary (Daniel H.); C. Ballantyne (Christie); J.P. Thiery (Joachim); A. Ziegler (Andreas); E. Lakatta (Edward); R.K. Chilukoti (Ravi Kumar); T.B. Harris (Tamara); P.A. Wolf (Philip); B.M. Psaty (Bruce); J.F. Polak (Joseph F.); X. Li (Xiaohui); W. Rathmann (Wolfgang); M. Uda (Manuela); E.A. Boerwinkle (Eric); N. Klopp (Norman); J.F. Wilson (James); J. Viikari (Jorma); W. Koenig (Wolfgang); S. Blankenberg (Stefan); A.B. Newman (Anne); J.C.M. Witteman (Jacqueline); G. Heiss (Gerardo); C.M. van Duijn (Cock); A. Scuteri (Angelo); G. Homuth (Georg); B.D. Mitchell (Braxton); V. Gudnason (Vilmundur); C.J. O'Donnell (Christopher)

    2011-01-01

    textabstractCarotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European

  7. Depressive symptoms and carotid intima-media thickness in South American Hispanics: results from the PREVENCION study.

    Science.gov (United States)

    Chirinos, Diana A; Medina-Lezama, Josefina; Salinas-Najarro, Belissa; Arguelles, William; Llabre, Maria M; Schneiderman, Neil; Paz-Manrique, Roberto; Bolanos, Juan F; Khan, Zubair; Chirinos, Julio A

    2015-04-01

    This study aimed to: (1) examine the relationship between depressive symptoms and subclinical atherosclerosis, measured by carotid intima-media thickness (IMT); and, (2) Determine the moderating effect of gender in this relationship among South American Hispanics. We studied 496 adults enrolled in the population-based PREVENCION study. Carotid IMT was measured with high-resolution ultrasonography. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale. Mean carotid IMT was 0.66 mm. (SD = 0.17) and mean depression score was 5.6 (SD = 3.5). Depressive symptoms were not associated with carotid IMT (β = 0.04, p = 0.222) in multivariate analyses. A significant moderating effect of gender was found (β for interaction = 0.10, p = 0.030), resulting from a significant association between depressive symptoms and carotid IMT in men but not women. Depressive symptoms were associated with subclinical atherosclerosis in South American Hispanic men but not women after controlling for demographic characteristics and traditional cardiovascular risk factors.

  8. Carotid intima-media thickness in individuals with and without type 2 diabetes

    DEFF Research Database (Denmark)

    Lundby-Christensen, Louise; Almdal, Thomas P; Carstensen, Bendix

    2010-01-01

    importance in order to make accurate power calculations and analyses of results, no reproducibility studies have been performed in this group of patients. The aim of this study was to quantify the variability of the measurement of carotid IMT in individuals with and without T2D. METHODS: We used B......-mode ultrasound and a computerized software programme (MIA vascular tools) for analysis of carotid IMT. Measurement of carotid IMT in the far wall of the common carotid artery (CCA) was done for 30 patients with T2D and 30 persons without T2D. The examinations were done by two different sonographers and two.......12 to 0.10 mm for persons without T2D. This means, that a second scanning of the same person with 95% probability would be within this interval of the first scanning. Comparisons between readers assessing the same scanning (reader variability) resulted in LoA from -0.05 to 0.07 mm and -0.04 to 0.05 mm...

  9. Thicker carotid intima-media thickness and increased plasma VEGF levels suffered by post-acute thrombotic stroke patients

    Directory of Open Access Journals (Sweden)

    Yueniwati Y

    2016-12-01

    Full Text Available Yuyun Yueniwati,1 Ni Komang Darmiastini,1 Eko Arisetijono2 1Radiology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia; 2Neurology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia Background and objectives: Atherosclerosis causes reduction of the oxygen supply to structures in the far arterial wall, provoking the release of factors that drive angiogenesis of vasa vasorum, including VEGF. Other studies have revealed the inflammatory response in atherosclerosis and the role of platelet factor 4 (PF4 as an anti-angiogenic chemokine through the inhibition of VEGF. This cross-sectional study aims at measuring the effect of atherosclerosis assessed through carotid intima-media thickness (CIMT against plasma VEGF levels in patients with post-acute thrombotic stroke. Materials and methods: CIMT was assessed sonographically using GE Logiq S6 with 13 MHz frequency linear probe. VEGF-A plasma levels were measured using enzyme-linked immunosorbent assay (ELISA method. Differences among variables were compared statistically. The data were analyzed using Pearson correlation. Results: A total of 25 patients with post-acute thrombotic stroke were identified in days 7 to 90. CIMT thickening was indicated in 88% of patients (1.202 ± 0.312 mm, while an increase in plasma VEGF was identified in all patients (178.28 ± 93.96 ng/mL. There was no significant correlation between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke (p=0.741. A significant correlation was recognized between CIMT and total cholesterol (p=0.029 and low-density lipoprotein (p=0.018. Conclusion: There were no significant correlations between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke. However, plasma VEGF increased in patients with thrombotic stroke. CIMT measurement is a promising noninvasive modality to assess the vascular condition of patients with stroke and diabetes, while plasma VEGF

  10. 高血压前期患者颈动脉内膜中层厚度与血压变异的相关性研究%Association of carotid artery intima-media thickness and blood pressure variation in patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    闫文珍; 王瑞英; 黄淑田

    2015-01-01

    目的:探讨高血压前期患者颈动脉内膜中层厚度(IMT)与血压变异的关系。方法392例高血压前期患者依据颈动脉 IMT 分为颈动脉增厚组204例、无颈动脉增厚组188例,超声测定颈动脉IMT,并且均行动态血压监测。结果(1)24 h 动态血压分析显示:颈动脉增厚组与无颈动脉增厚组平均收缩压[(136.85±9.67)mmHg 与(121.92±6.54)mmHg]、收缩压变异性[(4.13±0.67)%与(2.64±0.86)%]、舒张压变异性[(2.97±0.45)%与(2.06±0.36)%]比较差异均有统计学意义( t 值分别为21.08、5.97、3.32,P 均<0.05)。(2)24 h 动态血压与颈动脉 IMT 增厚率:随着收缩压变异性增大,颈动脉 IMT 增厚率增加(P =0.001),而舒张压变异性、平均舒张压与 IMT 增厚率无关(P 值分别为0.435、0.126);平均收缩压越大,IMT 增厚率越高(P =0.013)。(3)回归分析提示收缩压变异性、超敏 C 反应蛋白、平均收缩压、餐后2 h 血糖与 IMT 呈正相关。结论高血压前期患者收缩压变异性对 IMT 影响最大。%Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05

  11. Evaluation of cardiac structure, function and carotid artery intima-media thickness in overweight people with color Doppler ultrasonography%彩色多普勒超声评价超重人群心脏结构、功能及颈动脉内-中膜厚度

    Institute of Scientific and Technical Information of China (English)

    薛甜; 朱向明; 李国杰; 张青陵; 吴晶晶

    2011-01-01

    Objective To investigate the influence of overweight on cardiovascular system with color Doppler ultrasonography . Methods Totally 100 people accepted health examination were included and classified into 2 groups according to body mass index (BMI) : Overweight group (BMI≥25 kg/m2, n= 53 ) and control group (BMI<25 kg/m2, n= 47) , both underwent color Doppler ultrasonography . The heart structure , heart function and carotid artery intima-media thickness (IMT ) of them were compared . Results Compared with control group , left ventricular diameter in end diastole (LVDD) ,interventricular septum thickness (IVST ), left ventricular posterior wall thickness (LVPWT ), left ventricular mass (LVM ) , left ventricular mass index (LVMI) , peak A velocity (A) and IMT of overweight group all increased , peak Evelocity (E) and E/A both decreased (all P< 0. 05) . In all of 100 people , LVDD , IVST , LVPWT . LVM , LVMI, A and IMT were all positively correlated with BMI , E/A and E were both negatively correlated with BMI . Conclusion Ultrasound examination showed that injury of left ventricle structure . relaxing function and intima-media thickness can occur in overw eight without clinical symptoms .%目的 应用彩色多普勒超声检查观察超重对心脏结构、功能及颈动脉内-中膜厚度(IMT)的影响.方法 根据体质量指数(BMI)将100名体检者分为正常对照组(BMI<25 kg/m2,47名)和超重组(BMI≥25 kg/m2,53名).对两组均行彩色多普勒超声心动图及颈动脉超声检查,分析超重对心脏结构、功能及颈动脉IMT的影响.结果 与正常对照组相比,超重组左心室舒张末期内径(LVDD)、左心室舒张末期室间隔厚度(IVST)、左心室后壁舒张末期厚度(LVPWT)、左心室质量(LVM)、左心室质量指数(LVMI)、二尖瓣舒张晚期峰值血流速度(A峰)、颈动脉IMT增高,二尖瓣舒张早期峰值血流速度(E峰)和E/A降低,差异均有统计学意义(P均<0.05).BMI与LVDD、IVST、LVPWT

  12. Change in Elasticity Caused by Flow-Mediated Dilation Measured Only for Intima-Media Region of Brachial Artery

    Science.gov (United States)

    Sugimoto, Masataka; Hasegawa, Hideyuki; Kanai, Hiroshi

    2005-08-01

    Endothelial dysfunction is considered to be an initial step of arteriosclerosis [R. Ross: N. Engl. J. Med. 340 (2004) 115]. For the assessment of the endothelium function, brachial artery flow-mediated dilation (FMD) caused by increased blood flow has been evaluated with ultrasonic diagnostic equipment. In the case of conventional methods, the change in artery diameter caused by FMD is measured [M. Hashimoto et al.: Circulation 92 (1995) 3431]. Although the arterial wall has a layered structure (intima, media, and adventitia), such a structure is not taken into account in conventional methods because the change in diameter depends on the characteristic of the entire wall. However, smooth muscle present only in the media contributes to FMD, whereas the collagen-rich hard adventitia does not contribute. In this study, we measure the change in elasticity of only the intima-media region including smooth muscle using the phased tracking method [H. Kanai et al.: IEEE Trans. Ultrason. Ferroelectr. Freq. Control 43 (1996) 791]. From the change in elasticity, FMD measured only for the intima-media region by our proposed method was found to be more sensitive than that measured for the entire wall by the conventional method.

  13. Carotid Intima-Media Thickness in Indonesian Subjects with Cardiovascular Disease Risk Factors Who Were Not Receiving Lipid-Lowering Agents.

    Science.gov (United States)

    Kaligis, Rinambaan W M; Adiarto, Suko; Nugroho, Johanes; Pradnyana, Bagus Ari; Lefi, Achmad; Rifqi, Sodiqur

    2016-09-01

    Carotid intima-media thickness (CIMT) is frequently utilized for detection of subclinical atherosclerosis. This study aims to investigate the association between the CIMT values and demographic characteristics, cardiovascular disease (CVD) risk factors, lipid biochemistry profiles, and high-sensitivity C-reactive protein (hs-CRP) levels among the Indonesian population. Subjects who had two or more CVD risk factors but were not receiving lipid-lowering therapy were recruited from six hospitals of Indonesia. Measurements of CIMT are obtained by ultrasonography of 12 sites within the common carotid artery. CVD risk factors, lipid and glucose profiles, and hs-CRP values were analyzed with respect to distribution of CIMT. The mean-max CIMT was 0.805 ± 0.190 mm (minimum, 0.268 mm; maximum, 1.652 mm) and the mean-mean CIMT was 0.614 ± 0.190 mm (minimum, 0.127 mm; maximum, 1.388 mm). Multivariate analyses confirmed an independent association between increasing CIMT and increasing age (regression coefficient = 0.004; p = 0.004). Our data show normative mean-mean CIMT data for Indonesian subjects with two or more CVD risk factors who are not receiving lipid-lowering therapy, which may guide CVD risk stratification of asymptomatic individuals in Indonesia.

  14. Evaluating changes of carotid artery in patients with impaired glucose tolerance and type 2 diabetes mellitus with quantitative intima-media thickness and quantitative arterial stiffness%内中膜厚度定量及动脉僵硬度分析技术评价糖耐量减低及2型糖尿病者颈总动脉改变

    Institute of Scientific and Technical Information of China (English)

    谭丽芳; 艾红; 王娟; 石秀英; 淡敏

    2012-01-01

    目的 应用血管内中膜厚度定量(QIMT)及动脉僵硬度分析(QAS)技术评价糖耐量减低(IGT)和2型糖尿病(T2DM)患者颈总动脉结构及功能的改变.方法 对病例组68例患者[30例IGT(IGT亚组)和38例T2DM(T2DM亚组)]及58名正常对照(NC)组的右侧颈总动脉行QIMT、QAS及相关血清学检查,获取以下参数:内中膜厚度(IMT)、顺应性系数(CC)、扩张性系数(DC)、僵硬度参数(β)、2 h血糖值(2hPG)、甘油三酯(TG),胆固醇(Ch),低密度脂蛋白(LDL),糖化血红蛋白(GHb),并分析NC组与病例组各亚组之间的差异及相关性.结果 T2DM亚组DC低于NC组(P<0.05),其余参数组间两两比较差异均有统计学意义(P均<0.05);IGT和T2DM亚组β和IMT、2hPG、LDL与GHb均呈正相关(P均<0.01).结论 QIMT及QAS技术可反映动脉血管的早期结构及功能变化,对诊断IGT及T2DM患者早期动脉粥样硬化具有一定价值.%Objective To investigate the structural and functional changes of carotid artery in patients with type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT) with quantitative intima-media thickness (QIMT) and quantitative arterial stiffness (QAS) technique. Methods The right side-of common carotid artery of 68 patients (30 IGT and 38 T2DM ) and 58 healthy controls (NC group) were examined with QIMT, QAS technique and relative serological testing. Parameters including triglyceride (TG), low-density lipoprotein ( LDL) , cholesterol (Ch), glycosylated hemoglobin (GHb), intima-media thickness (IMT), compliance coefficient (CO, distensibility coefficient (DC), stiffness index (β) and 2 h plasma glucose (2hPG) of carotid obtained were acquired and the statistically analyzed. Results DC in T2DM subgroup was lower than in NC group, while the other parameters all had statistical differences among groups (all P<0. 05). There was positive correlation between β and IMT, 2hPG. LDL, GHb in IGT and T2DM subgroup (all P<0. 01). Conclusion QIMT and QAS

  15. Parental history of premature myocardial infarction is a stronger predictor of increased carotid intima-media thickness than parental history of hypertension.

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    Barra, S; Gaeta, G; Cuomo, V; Guarini, P; Cuomo, S; Capozzi, G; Tudisca, G; Madrid, A; Trevisan, M

    2011-06-01

    An increased carotid intima-media thickness (IMT) is detectable in young subjects with parental history of premature myocardial infarction (PHPMI) or hypertension (PHH). In this study we evaluated if PHPMI and PHH exert a different influence on carotid IMT and if their conjunction produces additive effects. High-resolution B-mode ultrasonographic evaluation of common carotid artery IMT was acquired from 48 subjects without PHPMI and PHH (22 males, 26 females; mean age 22.1±4.9 years; controls), 24 age- (±1 year) and sex-matched subjects with PHH without PHPMI (PHH-positive/PHPMI-negative subjects), 24 age- and sex-matched subjects with PHPMI without PHH (PHH-negative/PHPMI-positive subjects) and 24 age- and sex-matched subjects with both PHPMI and PHH (PHH/PHPMI-positive subjects). Lipid profile, resting blood pressure, smoking behaviour and body mass index (BMI) were also assessed. Carotid IMT was smaller in controls (0.41±0.07mm) compared to PHH-positive/PHPMI-negative subjects (0.47±0.10, p=0.023), to PHH-negative/PHPMI-positive subjects (0.54±0.11, p<0.001) and to PHH/PHPMI-positive subjects (0.52±0.10mm, p<0.001). Carotid IMT was greater in PHH-negative/PHPMI-positive (p=0.006) and in PHH/PHPMI-positive (p=0.031) than in PHH-positive/PHPMI-negative subjects. No difference in carotid IMT was evident between PHH-negative/PHPMI-positive and PHH/PHPMI-positive subjects (p=0.549). In the comparison among subjects using multiple regression analysis, only PHPMI, age and BMI were independently associated with carotid IMT. In healthy young subjects with PHPMI and/or PHH, carotid IMT is increased. PHPMI is a stronger predictor of increased carotid IMT than PHH. PHH in conjunction with PHPMI does not add any further detrimental effect on carotid IMT.

  16. Relationship between Waist Circumference and Elevation of Carotid Intima-media Thickness in Newly-diagnosed Diabetic Patients

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    ZHANG Lei; JIA Wei Ping; SHEN Yun; ZHOU Jian; PAN Jie Min; YU Hao Yong; CHEN Hai Bing; LI Qing; LI Ming; BAO Yu Qian

    2014-01-01

    Objective Waist circumference, as a brief indicator of visceral obesity, is associated with multi-metabolic disorders and cardiovascular diseases. The present study was aimed to find out the relationship between waist circumference and carotid intima media thickness (C-IMT), as well as the best waist circumference cutoff for identifying C-IMT elevation in Chinese male patients with newly-diagnosed diabetes. Methods Five hundred and seventy-eight patients from Department of Endocrinology and Metabolism in Shanghai Sixth People’s Hospital affiliated to Shanghai Jiao Tong University were enrolled. Both physical examination (for measurement of waist circumference) and carotid ultrasonography (for measurement of C-IMT) were performed. Results After grouping according to the quartiles of C-IMT, the waist circumference increased across all its quartiles. The waist circumference in 3rd and 4th quartiles (90.7±9.8 cm and 90.8±9.6 cm) was significant higher than in 1st and 2nd quartiles (P Conclusion Among newly-diagnosed diabetic male patients, waist circumference over 90 cm not only reflects sub-clinical atherosclerosis in early stage, but also predicts the progression of atherosclerosis.

  17. Lack of Association between ABO, PPAP2B, ADAMST7, PIK3CG, and EDNRA and Carotid Intima-Media Thickness, Carotid Plaques, and Cardiovascular Disease in Patients with Rheumatoid Arthritis

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    Raquel López-Mejías

    2014-01-01

    Full Text Available Introduction. Rheumatoid arthritis (RA is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV mortality. Recent studies have identified the ABO rs579459, PPAP2B rs17114036, and ADAMTS7 rs3825807 polymorphisms as genetic variants associated with coronary artery disease and the PIK3CG rs17398575 and EDNRA rs1878406 polymorphisms as the most significant signals related to the presence of carotid plaque in nonrheumatic Caucasian individuals. Accordingly, we evaluated the potential relationship between these 5 polymorphisms and subclinical atherosclerosis (assessed by carotid intima-media thickness (cIMT and presence/absence of carotid plaques and CV disease in RA. Material and Methods. 2140 Spanish RA patients were genotyped for the 5 polymorphisms by TaqMan assays. Subclinical atherosclerosis was evaluated in 620 of these patients by carotid ultrasonography technology. Results. No statistically significant differences were found when each polymorphism was assessed according to cIMT values and presence/absence of carotid plaques in RA, after adjusting the results for potential confounders. Moreover, no significant differences were obtained when RA patients were stratified according to the presence/absence of CV disease after adjusting for potential confounders. Conclusion. Our results do not confirm association between ABO rs579459, PPAP2B rs17114036, ADAMTS7 rs3825807, PIK3CG rs17398575, and EDNRA rs1878406 and subclinical atherosclerosis and CV disease in RA.

  18. Association of Plasma Adiponectin and Oxidized Low-Density Lipoprotein with Carotid Intima-Media Thickness in Diabetic Nephropathy

    Science.gov (United States)

    Georgoulidou, Anastasia; Roumeliotis, Athanasios; Roumeliotis, Stefanos; Giannakopoulou, Efstathia; Papanas, Nikolaos; Passadakis, Ploumis; Manolopoulos, Vangelis G.; Vargemezis, Vassilis

    2015-01-01

    Aims. We sought to determine the association between levels of adiponectin and oxidized low-density lipoprotein (ox-LDL) in patients with diabetic nephropathy as well as their effect on carotid intima-media thickness (cIMT). Methods. Adiponectin and ox-LDL were determined in 25 diabetic patients without nephropathy and 94 patients at different stages of diabetic nephropathy including subjects on hemodialysis. cIMT was measured using real-time B-mode ultrasonography. Results. Plasma adiponectin levels increased significantly with severity of diabetic nephropathy (P = 0.002), on the contrary to ox-LDL which decreased with disease severity (P < 0.001). cIMT was significantly higher at late stages of diabetic nephropathy compared with early stages (P = 0.022). Adiponectin was a significant negative predictor of ox-LDL levels (β = −5.45, P = 0.023), independently of confounding factors. There was no significant correlation between cIMT and adiponectin or ox-LDL either in the total sample population or according to disease staging. Cluster analysis showed that patients with the highest cIMT values, highest levels of adiponectin, and lowest levels of ox-LDL were included in one cluster and all assigned to stage 5 of diabetic nephropathy. Conclusions. There was no significant association between adiponectin or ox-LDL and cIMT and, therefore, other factors affecting this surrogate marker of cardiovascular disease in diabetic nephropathy should be sought. PMID:26064982

  19. Association of Plasma Adiponectin and Oxidized Low-Density Lipoprotein with Carotid Intima-Media Thickness in Diabetic Nephropathy

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    Anna Tavridou

    2015-01-01

    Full Text Available Aims. We sought to determine the association between levels of adiponectin and oxidized low-density lipoprotein (ox-LDL in patients with diabetic nephropathy as well as their effect on carotid intima-media thickness (cIMT. Methods. Adiponectin and ox-LDL were determined in 25 diabetic patients without nephropathy and 94 patients at different stages of diabetic nephropathy including subjects on hemodialysis. cIMT was measured using real-time B-mode ultrasonography. Results. Plasma adiponectin levels increased significantly with severity of diabetic nephropathy (P=0.002, on the contrary to ox-LDL which decreased with disease severity (P<0.001. cIMT was significantly higher at late stages of diabetic nephropathy compared with early stages (P=0.022. Adiponectin was a significant negative predictor of ox-LDL levels (β=-5.45, P=0.023, independently of confounding factors. There was no significant correlation between cIMT and adiponectin or ox-LDL either in the total sample population or according to disease staging. Cluster analysis showed that patients with the highest cIMT values, highest levels of adiponectin, and lowest levels of ox-LDL were included in one cluster and all assigned to stage 5 of diabetic nephropathy. Conclusions. There was no significant association between adiponectin or ox-LDL and cIMT and, therefore, other factors affecting this surrogate marker of cardiovascular disease in diabetic nephropathy should be sought.

  20. Are hepatic steatosis and carotid intima media thickness associated in obese patients with normal or slightly elevated gamma-glutamyl-transferase?

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    Tarantino Giovanni

    2012-03-01

    Full Text Available Abstract Background Hepatic steatosis (HS has been associated with obesity and metabolic syndrome (MS, conditions carrying a high risk of coronary artery disease. We aimed to determine whether HS was an independent factor of atherogenic risk beyond its association with MS and its components. Methods We assessed the circulating levels of the heat shock protein-70 (HSP-70, a chaperone involved in inflammation, endoplasmic reticulum stress and apoptosis at liver and endothelial level and the gamma-glutamyl transferase activity (γ-GT correlating them to carotid intima-media thickness (IMT, along with lipid profile, HOMA, C-reactive protein, fibrinogen, ferritin, adiposity type as well as spleen volume in 52 obese pts with grade 1, 128 with grade 2, and 20 with grade 3 of HS evaluated by sonography. Results Patients with different grade of HS demonstrated overlapping HSP-70 levels; similarly performed obese subjects regarding IMT. Using multiple regression analysis, IMT was predicted by age, visceral adiposity and by HOMA (β = 0.50, p p = 0.01 and β = 0.18, p = 0.048 respectively, while the severity of HS was predicted by visceral and subcutaneous adiposity and HOMA (β = 0.50, p p = 0.001 and β = 0.18, p = 0.024, respectively. Conclusion In our series of patients with normal or mild elevation of γ-GT, the severity of HS does not entail higher IMT, which may be linked to MS stigmata.

  1. 冠心病患者颈动脉内膜中层厚度、微量白蛋白尿与冠脉狭窄程度的相关性分析%The analysis of the correlation between coronary heart disease patients with carotid intima -media thickness, ;microalbuminuria and the degree of coronary artery stenosis

    Institute of Scientific and Technical Information of China (English)

    王健; 滕涛

    2015-01-01

    目的:观察冠心病患者尿微量白蛋白、颈动脉内膜中层厚度(CIMT)及冠脉 Gensini 评分水平,探讨冠脉狭窄程度与尿微量白蛋白、颈动脉内膜中层厚度的相关性。方法选取冠心病住院患者50例及健康对照组50例,比较两组间尿微量白蛋白、CIMT 及冠脉 Gensini 评分。结果冠心病组尿微量白蛋白、CIMT分别为(38.36±19.51)mg/L、(1.18±0.25)mm,健康对照组尿微量白蛋白、CIMT 分别为(27.52±15.44)mg/L、(0.76±0.17)mm,两组差异均有统计学意义(t =3.080,P =0.002;t =9.823,P =0.000),冠心病组冠脉 Gensini评分与尿微量白蛋白、CIMT 呈正相关(r =0.288,P =0.430;r =0.308,P =0.290)。结论冠心病患者尿微量白蛋白、CIMT 与冠脉狭窄程度呈正相关关系,通过测定尿微量白蛋白及颈动脉内膜中层厚度,可预测冠状动脉狭窄程度。%Objective To observe the microdose albumin in urine,carotid intima -media thickness(CIMT) of coronary heart disease(CHD)patients′and coronary Gensini score level,to investigate the correlation between the extent of coronary stenosis and microalbuminuria,CIMT.Methods 50 cases of hospitalized patients with CHD and healthy control group of 50 cases were selected,to compare the score between the two groups of microalbuminuria, CIMT and coronary Gensini.Results CHD group:microalbuminuria and CIMT were (38.36 ±19.51 )mg/L, (1.18 ±0.25)mm respectively.Healthy control group:microalbuminuria and CIMT were (27.52 ±15.44)mg/L, (0.76 ±0.17)mm respectively.Differences between the two groups were statistically significant(t =3.080,P =0.002;t =9.823,P =0.000).CHD group:coronary Gensini score was positively correlated with microalbuminuria, CIMT(r =0.288,P =0.430 r =0.308,P =0.290).Conclusion The correlation between CHD patients'microalbu-minuria,CIMT and the degree of coronary artery stenosis is positive

  2. 厄贝沙坦对轻中度高血压颈动脉内膜中层厚度及动脉弹性的影响%The effect of irbesartan on improving carotid intima-media thickness and arterial elasticity in patients with mild to moderate hypertension

    Institute of Scientific and Technical Information of China (English)

    魏玉杰; 刘惠亮; 张敏; 田蕾

    2010-01-01

    目的 观察厄贝沙坦对轻中度高血压颈动脉内膜中层厚度及动脉弹性的影响.方法 选取符合入选标准的轻中度原发性高血压106例,应用彩色多普勒超声检测颈总动脉内膜中层厚度(carotid intima-media thickness,IMT),脉搏波速度测定仪同时检测颈动脉-桡动脉(carotid-radial pulse wave velocity,C-RPWV)、颈动脉-股动脉(carotid-femoral carotid-radial ,C-FPWV)的脉搏波速度.给予以厄贝沙坦为基础的降压治疗,根据患者的血压反应加用小剂量氢氯噻嗪,12周后超声复查颈动脉内膜中层厚度及脉搏波速度.结果 与治疗前相比,治疗后收缩压(SBP)和舒张压(DBP)均明显下降(P<0.05);IMT显著减少(P<0.01);C-RPWV、C-FPWV明显减慢(P<0.01).结论 厄贝沙坦除能有效降低血压外,还能改善动脉重构.

  3. Influence of age, body mass index, and blood pressure on the carotid intima-media thickness in normotensive and hypertensive patients.

    Science.gov (United States)

    Honzikova, Natasa; Labrova, Ruzena; Fiser, Bohumil; Maderova, Eva; Novakova, Zuzana; Zavodna, Eva; Semrad, Borivoj

    2006-10-01

    We investigated whether body mass index and blood pressure have an additive influence on the carotid intima-media thickness (IMT). In 27 patients treated for hypertension (47.2+/-8.7 years) and 23 normotensive subjects (44.1+/-8.1 years), 24-h recording of blood pressure was performed. The carotid IMT was determined by ultrasonography and baroreflex sensitivity by a spectral method from 5-min recordings of blood pressure. Significant differences between hypertensive and normotensive subjects were observed for carotid IMT (0.60+/-0.08 vs. 0.51+/-0.07 mm; pmass index (pinfluenced by either age or body mass index. Baroreflex sensitivity decreased with age (pinfluence of age and body mass index on the development of carotid IMT is essential only in normotensive subjects. In hypertensive subjects the influence of blood pressure predominates, as documented by a comparison of the carotid IMT between hypertensive and normotensive subjects.

  4. Effect of a Mediterranean diet on endothelial progenitor cells and carotid intima-media thickness in type 2 diabetes: Follow-up of a randomized trial.

    Science.gov (United States)

    Maiorino, Maria Ida; Bellastella, Giuseppe; Petrizzo, Michela; Gicchino, Maurizio; Caputo, Mariangela; Giugliano, Dario; Esposito, Katherine

    2017-03-01

    Background We assessed the long-term effects of a Mediterranean diet on circulating levels of endothelial progenitor cells (EPCs) and the carotid intima-media thickness (CIMT) in patients with type 2 diabetes. Design This was a parallel, two-arm, single-centre trial. Methods Two hundred and fifteen men and women with newly diagnosed type 2 diabetes were randomized to a Mediterranean diet ( n = 108) or a low-fat diet ( n = 107). The primary outcome measures were changes in the EPC count and the CIMT of the common carotid artery after the treatment period defined as the end of trial (EOT). Results At the EOT, both the CD34(+)KDR(+) and CD34(+)KDR(+)CD133(+) counts had increased with the Mediterranean diet compared with the low-fat diet ( p Mediterranean diet. Compared with the low-fat diet, the rate of regression in the CIMT was higher in the Mediterranean diet group (51 vs. 26%), whereas the rate of progression was lower (25 vs. 50%) ( p = 0.032 for both). Changes in the CIMT were inversely correlated with the changes in EPC levels (CD34(+)KDR(+), r = -0.24, p = 0.020; CD34(+)KDR(+)CD133(+), r = -0.28, p = 0.014). At the EOT, changes in levels of HbA1c, HOMA, total cholesterol, high-density lipoprotein cholesterol and systolic blood pressure were significantly greater with the Mediterranean diet than with the low-fat diet. Conclusion Compared with a low-fat diet, a long-term trial with Mediterranean diet was associated with an increase in circulating EPCs levels and prevention of the progression of subclinical atherosclerosis in patients with newly diagnosed type 2 diabetes.

  5. Visit-to-Visit Low-Density Lipoprotein Cholesterol Variability Is an Independent Determinant of Carotid Intima-Media Thickness in Patients With Type 2 Diabetes

    Science.gov (United States)

    Takenouchi, Akiko; Tsuboi, Ayaka; Kitaoka, Kaori; Minato, Satomi; Kurata, Miki; Fukuo, Keisuke; Kazumi, Tsutomu

    2017-01-01

    Background Studies demonstrated that visit-to-visit variability in low-density lipoprotein cholesterol (LDLC) is an independent predictor of cardiovascular events in subjects with coronary artery disease. Whether visit-to-visit variability in LDLC levels affects subclinical atherosclerosis is unknown. This study sought to evaluate the role of visit-to-visit variability in LDLC levels on subclinical atherosclerosis. Methods We evaluated 162 type 2 diabetic patients with measurement of carotid intima-media thickness (IMT). Intrapersonal mean and standard deviation (SD) of six measurements of LDLC during 12 months were calculated. Multivariate linear regressions assessed the independent correlates of carotid IMT. Results The mean and SD of LDLC were 112 ± 22 and 15 ± 10 mg/dL, respectively, and 43.2% of patients were on hypolipidemic drugs. Age (standardized β = 0.355, P index (BMI), waist circumference, duration and treatment of diabetes, means and SDs of glycemic and other lipid variables, and uses of hypolipidemic and anti-hypertensive medications (R2 = 0.15). Results did not change when mean IMT was used instead of maximum IMT. After controlling for age and sex, maximum IMT was thicker in patients with the highest compared to those with other three quartiles of SD-LDLC combined (1.14 ± 0.04 (SE) vs. 1.01 ± 0.02 mm, P = 0.01). Independent determinants of SD-LDLC were mean LDLC, use of hypolipidemic drugs, fasting triglyceride and visit-to-visit variability in HbA1c. Conclusions Consistency of LDLC levels may be important to subclinical atherosclerosis in real-world patients with type 2 diabetes. It may be important for patients on lipid-lowering drugs to prevent non-compliance. PMID:28270891

  6. Plasma renin responses to mental stress and carotid intima-media thickness in black Africans: the SABPA study.

    Science.gov (United States)

    Hamer, M; Malan, L; Schutte, A E; Huisman, H W; van Rooyen, J M; Schutte, R; Fourie, C M T; Malan, N T; Seedat, Y K

    2011-07-01

    The renin-angiotensin-aldosterone system can be activated by sympathetic nervous input and is thought to have an important role in the prevalence of hypertension and cardiovascular risk in black Africans. We examined (1) the association between plasma renin responses to mental stress and a marker of sub-clinical atherosclerosis; and (2) associations between resting renin and 24-h ambulatory blood pressure. Participants were 143 urbanized black African men and women (43.1 ± 7.7 years) drawn from a study of Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA). After an overnight fast, participants completed the Stroop mental stress task. Blood samples were drawn during baseline and 10 min after the task to assess the concentration of active renin in plasma. Blood pressure assessments included continuous Finometer measures during the stress testing and 24-h ambulatory monitoring. Carotid intima-media thickness (CIMT) was measured using high-resolution ultrasound. Approximately 50% of the sample responded to the task with an increase in renin concentration. Multiple linear regression analysis revealed an association between the renin stress response and CIMT (β = 0.024, 95% confidence interval, 0.004-0.043), after adjustment for conventional risk factors, blood pressure stress responses and basal levels of renin activity (R(2) for model = 0.37). In addition, resting renin was inversely associated with ambulatory blood pressure. In summary, heightened release of renin during a laboratory mental stressor was associated with a marker of sub-clinical atherosclerosis; thus, it may be a potential mechanism in explaining the increased burden of cardiovascular disease in urbanized black Africans.

  7. Influence of obstructive sleep apnea on ischemia-modified albumin levels and carotid intima-media thickness.

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    Karamanli, Harun; Kiyici, Aysel; Arik, Bilal; Efe, Duran; Akgedik, Recep

    2016-06-01

    Obstructive sleep apnea (OSA) is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (CIMT) is strongly associated with the presence of significant risk factors for cardiovascular disturbances. A disturbance in the oxidative/antioxidative balance is involved in the pathogenesis of OSA and cardiovascular diseases. Ischemia-modified albumin (IMA) is suggested as a novel marker of oxidative stress; IMA can be defined as decreased binding of transitional metal ions to serum albumin in oxidative status. The purpose of this research was to evaluate the influence of OSA on IMA levels and CIMT. In total, 61 individuals with OSA with no comorbidities and 24 healthy controls with a similar body mass index and age were enrolled in this study. Serum levels of IMA, CIMT (estimated radiologically), and polysomnographic parameters, were determined and interpreted. Serum IMA levels were significantly higher in individuals with OSA compared with the control group (p=0.0003). CIMT was significantly higher in the OSA group compared with the control group (0.88± 0.26 mm vs 0.75±0.17 mm, p=0.005). The CIMT and serum IMA levels were positively correlated with the apnea-hypopnea index (r=0.35 and r=0.32, respectively), and with the oxygen desaturation index (r=0.34 and r=0.29, respectively) at baseline. Increased IMA levels and CIMT may be related to increased oxidative stress and risk of atherosclerosis in individuals with OSA.

  8. Attenuation of rate of change in carotid intima-media thickness by lipid-modifying drugs: impact on clinical outcomes.

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    Peters, Sanne A E; den Ruijter, Hester M; Bots, Michiel L

    2011-08-01

    Measurements of carotid intima-media thickness (CIMT) are widely used in clinical research as a measure of atherosclerosis. Many randomized controlled trials (RCTs) have been performed using the rate of change in CIMT as the primary endpoint to study the efficacy of lipid-modifying therapies. The main advantage of using CIMT over the use of cardiovascular events as a primary endpoint is the greater efficiency and feasibility. The underlying assumption for the use of CIMT in trials is that the rate of change in CIMT achieved by a therapy reflects a change in the risk for cardiovascular events. We therefore set out to assess the evidence showing whether the rate of change in CIMT induced by lipid-lowering therapies has an impact on clinical outcomes, by reviewing the available evidence based on a search of the PubMed database. Solid evidence from observational studies shows that increased CIMT relates to an increase in cardiovascular risk. RCTs consistently demonstrate that the annual rate of change in CIMT is favourably affected by lipid-modifying therapies. One study investigating the relationship between the rate of change in CIMT and clinical events has been published and showed a positive relationship between these two outcomes. A published meta-analysis based on pooled CIMT data from statin trials has shown a positive relationship between attenuated rate of change in CIMT after statin therapy and clinical outcomes. However, methodological issues question the validity of the meta-analytical approach. The consistent agreement between results from CIMT trials and event trials on the effects of lipid-modifying therapies, however, clearly supports the presence of a relationship between changes in CIMT and clinical endpoints. Therefore, although direct evidence is scarce, the data overall on whether the attenuation of rate of change in CIMT by lipid-lowering therapies impact on clinical outcomes are supportive.

  9. Effects of testosterone replacement therapy on carotid artery intima-media thickness in middle-aged and elderly male patients%睾酮补充治疗对中老年男性颈动脉内膜中层厚度的影响

    Institute of Scientific and Technical Information of China (English)

    康冬梅; 沈干; 刘燕; 朱翔; 沈国栋; 胡世莲

    2013-01-01

    Objective To investigate the effects of testosterone (T) replacement therapy (TRT) on carotid artery intima-media thickness (IMT) in middle aged and elderly male patients.Methods A total of 80 middle-aged and elderly male patients with testosterone deficiency and increased carotid artery IMT were selected and randomly divided into two groups:the treatment group (n=38,treated with testosterone for 1 year) and the control group (n=42,without any treatment).The serum T level,IMT and prostate-specific antigen (PSA) before and after treatment were determined.The correlation between the testosterone level and carotid artery IMT was analyzed.Results There were no significant differences in the serum T level and IMT between the control group and the treatment group before treatment [(10.39 ± 1.44) nmol/L vs.(10.88 ± 1.87) nmol/L,(1.25 ±0.11) mm vs.(1.24±0.13) mm,t=1.32,-0.26,P=0.191,0.794].Compared with pretreatment,the serum T level was significantly increased and the IMT was significantly decreased in the treatment group afterTRT [(10.88±1.87) nmol/L vs.(22.83±1.56) nmol/L,(1.24±0.13) mmvs.(1.18±0.16) mm,t=-29.14,2.55,P=0.000,0.015],while no significant differences in the serum T level and IMT were found in the control group before and after treatment [(10.39± 1.44)nmol/L vs.(9.99±1.72) nmol/L,(1.25±0.11) mm vs.(1.27±0.11) mm,t=1.24,-1.00,P =0.219,0.323].Linear correlation analysis showed that the serum T level was negatively correlated with IMT (r-0.605,P=0.000) and multiple regression analysis showed that the T level was an independent factor for IMT.Conclusions Testosterone replacement therapy is an effective treatment to alleviate IMT in middle-aged and elderly male patients,which may play an important role in preventing cardiovascular diseases in middle-aged and elderly male patients.%目的 观察睾酮补充治疗对中老年男性颈动脉内膜中层厚度(IMT)的影响. 方法 选取2008年10月至2011年11月在我院保健中心及门诊体检血

  10. The Effect of Sitagliptin on the Regression of Carotid Intima-Media Thickening in Patients with Type 2 Diabetes Mellitus: A Post Hoc Analysis of the Sitagliptin Preventive Study of Intima-Media Thickness Evaluation

    Science.gov (United States)

    Katakami, Naoto; Shiraiwa, Toshihiko; Yoshii, Hidenori; Gosho, Masahiko; Shimomura, Iichiro; Watada, Hirotaka

    2017-01-01

    Background. The effect of dipeptidyl peptidase-4 (DPP-4) inhibitors on the regression of carotid IMT remains largely unknown. The present study aimed to clarify whether sitagliptin, DPP-4 inhibitor, could regress carotid intima-media thickness (IMT) in insulin-treated patients with type 2 diabetes mellitus (T2DM). Methods. This is an exploratory analysis of a randomized trial in which we investigated the effect of sitagliptin on the progression of carotid IMT in insulin-treated patients with T2DM. Here, we compared the efficacy of sitagliptin treatment on the number of patients who showed regression of carotid IMT of ≥0.10 mm in a post hoc analysis. Results. The percentages of the number of the patients who showed regression of mean-IMT-CCA (28.9% in the sitagliptin group versus 16.4% in the conventional group, P = 0.022) and left max-IMT-CCA (43.0% in the sitagliptin group versus 26.2% in the conventional group, P = 0.007), but not right max-IMT-CCA, were higher in the sitagliptin treatment group compared with those in the non-DPP-4 inhibitor treatment group. In multiple logistic regression analysis, sitagliptin treatment significantly achieved higher target attainment of mean-IMT-CCA ≥0.10 mm and right and left max-IMT-CCA ≥0.10 mm compared to conventional treatment. Conclusions. Our data suggested that DPP-4 inhibitors were associated with the regression of carotid atherosclerosis in insulin-treated T2DM patients. This study has been registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000007396). PMID:28250768

  11. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  12. Correlation between coronary artery SYNTAX integra and estimated glomerular filtration rate and carotid intima-media thickness in eldly patients with coronary artery disease%冠状动脉SYNTAX积分与内生肌酐清除率及颈动脉内膜中层厚度的相关性

    Institute of Scientific and Technical Information of China (English)

    申琳

    2014-01-01

    目的:探讨老年冠心病患者冠状动脉(冠脉)SYNTAX积分与肾小球滤过率估算值(estimated glo-merular filtration rate,eGFR)及颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)的关系.方法:回顾性分析在我院经造影证实3支病变和(或)左主干病变的老年冠心病患者43例,计算SYNTAX积分并进行危险分层,利用Cockcroft-Gault公式计算eGFR,采用超声测定CIMT,分析患者SYNTAX积分与eGFR及CIMT的关系.多元线性回归分析法分析影响SYNTAX积分的危险因素.结果:老年冠心病患者SYNTAX评分与eGFR呈负相关(r=一0.36,P<0.05);SYNTAX评分与CIMT呈正相关(r=0.33,P<0.05);CIMT与eGFR负相关(r=-0.47,P<0.05).将患者以SYNTAX积分(低危0~22分,中危23~32分,高危≥33分)进行分层分析,低危组与中危组、低危组与高危组CIMT差异有统计学意义(P<0.05),低危组与中危组及高危组eGFR差异有统计学意义(P<0.05).eGFR(β=-0.1834,P=0.002 4)是SYNTAX积分的独立危险因素.结论:颈动脉内膜的变化与冠脉病变相关;随着老年冠心病患者肾脏功能的减退,动脉粥样硬化有逐渐加重的趋势.

  13. Bariatric surgery decreases carotid intima-media thickness in obese subjects.

    Science.gov (United States)

    García, Gonzalo; Bunout, Daniel; Mella, Javiera; Quiroga, Erik; de la Maza, María Pía; Cavada, Gabriel; Hirsch, Sandra

    2013-01-01

    Introducción: La obesidad se ha asociado a un aumento del riesgo cardiovascular. El objetivo de este estudio fue evaluar el impacto de la baja de peso a través de la cirugía bariátrica en el grosor íntima media carotídea (GIMc, marcador subrogado de aterosclerosis subclínica) y los factores de riesgo cardiovascular clásicos. Métodos: Un total de 31 pacientes obesos fueron evaluados para cirugía bariátrica, 27 fueron intervenidos quirúrgicamente, 14 sometidos a un bypass gástrico en Y de Roux y 13 a gastrectomía en manga. En los 4 pacientes que no fueron sometidos a cirugía bariátrica se realizó las mismas evaluaciones. Parámetros: peso, índice de masa corporal (IMC), presión arterial, colesterol total, LDL, HDL, triglicéridos, glicemia e insulina de ayunas, HOMA IR y medición del GIMc mediante ultrasonido. Resultados: Luego de 354 + 92 días de seguimiento, en los 27 pacientes intervenidos se evidenció una disminución del IMC promedio de 38 a 27 k/m2 (p < 0,001), al mismo tiempo se observó una reducción en los marcadores de riesgo cardiovascular, en el riesgo de Framingham a 10 años, y una significativa reducción de la terapia farmacológica. El promedio del GIMc se redujo de 0,58 ± 0,14 mm a 0,49 ± 0,09 mm (p = 0,0001). Los cuatro pacientes que no fueron intervenidos presentaron un aumento del GIMc 0,52 ± 0,12 a 0,58 ± 0,13 mm (p = 0,03) sin cambios significativos en los marcadores de riesgo cardiovascular durante el período observado. Conclusión: La pérdida de peso inducida por la cirugía bariátrica, tanto bypass gástrico como gastrectomía en manga, a un año de seguimiento disminuye el GIMc, mejora los factores de riesgo cardiovascular y el riesgo de Framingham a 10 años.

  14. Intima-media thickness of the descending aorta in patients with bicuspid aortic valve

    Directory of Open Access Journals (Sweden)

    Johan Petrini

    2016-06-01

    Conclusions: Intima-media thickness of the descending aorta is not affected by aortic valve morphology (BAV/TAV; age is the main determinant of AoIMT. Genetic markers (SNPs known to influence IMT in the carotid artery seem to correlate to IMT in the descending aorta only in patients with TAV.

  15. Relationship between blood pressure variability, C-reactive protein and intima-media thickness of carotid artery%血压变异性与高敏C反应蛋白及颈动脉内膜中层厚度的关系

    Institute of Scientific and Technical Information of China (English)

    陈平安; 刘戬; 李韶南

    2012-01-01

    Objective:To explore the correlation between blood pressure variability (BPV), high sensitive C-reactive protein (hs-CRP), angiotensin-contracting-enzyme (ACE), and intima-media thickness (IMT) of carotid artery in patients with essential hypertention. Method:One hundred and twenty-six patients with essential hyper-tention were divided into three groups, according to standard deviation (SD) of night systolic blood pressure (SBP), high BPV group, median BPV group and low BPV group. IMT and plaque were measured by Doppler ultrasound. Levels of hs-CRP and ACE were detected by automatic chemistry analyzer. Result; Hs-CRP and IMT were higher in high BPV group than those in low BPV group [hs-CRP:(3. 78 ± 3. 63)mg/L vs (2. 24±1. 92)mg/ L; IMT:(1. 01±0. 16)mm vs (0. 91±0. 17)mm, all P<0. 05]. We also observed IMT was higher in patients whose 24-hour mean blood pressure (24 hmBP) was controlled than that in those 24 hmBP was not controlled well [(1. 00±0. 19)mm vs (0. 93 ± 0. 16)mm, P<0. 05]. SSD was higher in high IMT group than that in IMT normal group. Correlation analysis showed a significantly positive correlation between IMT and 24hmSBP, daytime mSBP, night mean SBP, SD of night SBP, SD of night DBP and LDL (r=0. 218, 0. 211, 0. 210, 0. 176, 0. 191, 0. 267). Mutiple linear regression analysis also showed a positive correlation between IMT and 24 hmSBP, LDL. Conclusion:BPV closely relates to hs-CRP and IMT.%目的:探讨高血压患者血压变异性(BPV)与高敏C反应蛋白(hs-CRP)及颈动脉内膜中层厚度(IMT)的关系.方法:依据夜间收缩压标准差的三分位间距将126例高血压患者分为低BPV组、中BPV组和高BPV组.彩色多普勒超声仪测定IMT和颈动脉斑块,同时检测血浆hs-CRP和血管紧张素转化酶(ACE).结果:高BPV组hs-CRP水平和IMT较低BPV组增加[hs-CRP:(3.78±3.63)mg/L:(2.24±1.92) mg/L;IMT:(1.01±0.16)mm:(0.91±0.17)mm;均P<0.05].24 h血压不达标亚组IMT较达标亚组明显增加[(1.00±0.19)mm:(0

  16. 亚临床甲状腺功能减退患者中医体质分型及其与颈动脉内膜中层厚度的相关性%Correlation Between Distribution of TCM Constitutional Types and Carotid Artery Intima-media Thickness in Patients with Subclinical Hypothyroidism

    Institute of Scientific and Technical Information of China (English)

    李胜男; 滕涛

    2015-01-01

    Objective To discuss the correlation between the distribution of TCM constitutional types and carotid artery intima-media thickness (CIMT) in patients with subclinical hypothyroidism;To select the biased constitution type with high risk factors for atherosclerosis;To provide theoretical basis for preventing this disease from the perspective of TCM physique. Methods Totally 120 patients with subclinical hypothyroidism and 50 cases of normal healthy subjects were selected. TCM constitutional types of two groups were distinguished by KY3H TCM physique recognition software. CIMT was determined, and the correlation between the distribution of TCM constitutional types and CIMT in patients with subclinical hypothyroidism was analyzed. Results In 120 cases of subclinical hypothyroidism, there were 3 cases of gentleness type (2.50%), 30 cases of qi-depression type (25.00%), 28 cases of qi-deficiency type (23.33%), 25 cases of yang-deficiency type (20.83%), 13 cases of phlegm-damp type (10.84%), 9 cases of yin-deficiency type (7.50%), 6 cases of blood stasis type (5.00%), 5 cases of dampness heat type (4.17%), 1 case of particular type (0.83%). The main TCM constitutional types of subclinical hypothyroidism were qi-depression type, qi-deficiency type, yang-deficiency type and phlegm-damp type. The morbidity of atherosclerosis in patients with qi-depression type and qi-deficiency type were higher than other constitutional types. Conclusion The main TCM constitutional types of subclinical hypothyroidism were qi-depression type, qi-deficiency type, yang-deficiency type and phlegm-damp type.%目的:探讨亚临床甲状腺功能减退(以下简称“亚临床甲减”)患者中医体质类型特点及其与颈动脉内膜中层厚度的关系,筛选出存在动脉粥样硬化高危险因素的偏颇体质类型,为从中医体质角度预防本病提供依据。方法选取亚临床甲减者120例,正常健康者50例,均采用北京炎黄东方健康

  17. Serum carotenoids reduce progression of early atherosclerosis in the carotid artery wall among Eastern Finnish men.

    Directory of Open Access Journals (Sweden)

    Jouni Karppi

    Full Text Available BACKGROUND: Several previous epidemiologic studies have shown that high blood levels of carotenoids may be protective against early atherosclerosis, but results have been inconsistent. We assessed the association between atherosclerotic progression, measured by intima-media thickness of the common carotid artery wall, and serum levels of carotenoids. METHODS: We studied the effect of carotenoids on progression of early atherosclerosis in a population-based study. The association between concentrations of serum carotenoids, and intima-media thickness of the common carotid artery wall was explored in 840 middle-aged men (aged 46-65 years from Eastern Finland. Ultrasonography of the common carotid arteries were performed at baseline and 7-year follow-up. Serum levels of carotenoids were analyzed at baseline. Changes in mean and maximum intima media thickness of carotid artery wall were related to baseline serum carotenoid levels in covariance analyses adjusted for covariates. RESULTS: In a covariance analysis with adjustment for age, ultrasound sonographer, maximum intima media thickness, examination year, body mass index, systolic blood pressure, smoking, physical activity, serum LDL cholesterol, family history of coronary heart disease, antihypertensive medication and serum high sensitivity C-reactive protein, 7-year change in maximum intima media thickness was inversely associated with lycopene (p = 0.005, α-carotene (p = 0.002 and β-carotene (p = 0.019, respectively. CONCLUSIONS: The present study shows that high serum concentrations of carotenoids may be protective against early atherosclerosis.

  18. Endothelial dysfunction and brachial intima-media thickness: long term cardiovascular risk with claudication related to peripheral arterial disease: a prospective analysis.

    Directory of Open Access Journals (Sweden)

    Franz Hafner

    Full Text Available OBJECTIVE: Endothelial dysfunction plays a key role in the development, progression, and clinical manifestation of atherosclerosis, and in symptomatic peripheral arterial disease, endothelial dysfunction and enlarged intima-media thickness might be associated with increased cardiovascular risk. Flow-mediated dilatation and serologic parameters are used to evaluate individual endothelial function. Brachial intima-media thickness, a less recognized parameter of cardiovascular risk, is independently associated with coronary artery disease. The aim of this study was to evaluate the prognostic value of ultrasound and serologic parameters of endothelial function in relation to cardiovascular mortality in peripheral arterial disease. DESIGN: monocentric, prospective cohort study. METHODS: Flow mediated dilatation and brachial intima-media thickness were assessed in 184 (124 male patients with peripheral arterial disease (Rutherford stages 2-3. Serologic parameters of endothelial function included asymmetric dimethylarginine (ADMA, symmetric dimethylarginine (SDMA, and L-homoarginine. Cardiovascular events were recorded during a follow-up of 99.1±11.1 months. Subjects who died of noncardiovascular causes were excluded from further analysis. RESULTS: Eighty-two patients (44.6% died during follow-up after a mean duration of 49.7±28.3 months. There were 49 cardiovascular deaths (59.8% and 33 other deaths (40.2%. Flow mediated dilatation was associated with cardiovascular death [1.17% (0.0, 4.3 vs. 4.1% (1.2, 6.4, p<0.001]. Intima-media thickness was greater in patients who succumbed to cardiovascular disease [0.37 mm (0.30, 0.41] than in survivors [0.21 mm (0.15, 0.38, p<0.001]. Brachial intima-media thickness above 0.345 mm was most predictive of cardiovascular death, with sensitivity and specificity values of 0.714 and 0.657, respectively (p<0.001. Furthermore, ADMA levels above 0.745 µmol/l and SDMA levels above 0.825 µmol/l were significantly

  19. Ultrasound protocols to measure carotid intima-media thickness in trials; comparison of reproducibility, rate of progression, and effect of intervention in subjects with familial hypercholesterolemia and subjects with mixed dyslipidemia.

    NARCIS (Netherlands)

    Dogan, S.; Duivenvoorden, R.; Grobbee, D.E.; Kastelein, J.J.; Shear, C.L.; Evans, G.W.; Visseren, F.L.; Bots, M.L.

    2010-01-01

    BACKGROUND: Current ultrasound protocols to measure carotid intima-media thickness (CIMT) in trials rather differ. The ideal protocol combines high reproducibility with a high precision in the measurement of the rate of change in CIMT over time and with a precise estimate of a treatment effect. To s

  20. 心脏瓣膜钙化与颈动脉内膜中层厚度的相关性研究%Relationship of Heart Valve Calcification and Carotid Intima Media Thickness

    Institute of Scientific and Technical Information of China (English)

    贾彦青; 党群; 姚民强; 李永健

    2012-01-01

    目的:研究心脏瓣膜钙化程度与颈动脉内膜中层厚度、斑块积分的相关性.方法:用经胸多普勒超声显像仪评估426例患者心脏瓣膜钙化情况,根据瓣膜钙化诊断标准将所有患者分为无钙化组、轻度钙化组、中度钙化组和重度钙化组.比较4组间的一般资料、病史、血压、血脂,同时测量4组患者颈动脉内膜中层厚度、软斑块积分、硬斑块积分及总斑块积分.结果:4组间的年龄、性别、体质量指数、吸烟情况、总胆固醇、三酰甘油、高密度脂蛋白胆固醇,低密度脂蛋白胆固醇差异无统计学意义;瓣膜钙化程度与冠心病患病率、收缩压、脉压、颈动脉内膜中层厚度、总斑块积分、硬斑块积分呈正相关(r.分别为0.546、0.628、0.512、0.802、0.628、0.544,均P<0.001),与舒张压、软斑块积分无相关性.结论:心脏瓣膜钙化程度可作为推测颈动脉内膜中层厚度、总斑块积分、硬斑块积分的一个重要指标.%Objective:To investigate the relationship between the degree of heart valve calcification and carotid intima media thickness and plaque integral. Methods: The valve calcification was assessed using transthoracic Doppler ultrasound imaging in 426 patients. All patients were divided into four groups according to the diagnostic criteria, including no calcification group, mild calcification group, moderate and severe calcification group. The general information, medical history, blood pressure, blood lipids were compared between four groups. The intima media thickness, suft plaque score, hard plaque score and the total plaque score of carotid artery were also measured in patients of four groups. Results: There were no significant differences in age, gender, body mass index, smoking status, total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein between four groups. The degree of valve calcification was positively correlated with

  1. The triple line pattern on carotid intima media thickness imaging and its relationship to cardiovascular risk factors in patients on lipid lowering therapy

    Directory of Open Access Journals (Sweden)

    Singh TA

    2014-06-01

    Full Text Available Tania A Singh,1 Todd C Villines,2 Allen J Taylor31Division of Cardiology, Medstar Georgetown University Hospital, 2Walter Reed National Military Medical Center, Bethesda, MD, 3Georgetown University School of Medicine, Washington, DC, USA Background: Carotid intima media thickness (CIMT infrequently identifies a triple line pattern (TLP in the visualization of the internal elastic lamina. We examined the prevalence and predictors of the TLP among a consecutive series of subjects enrolled in a CIMT clinical trial, and also the effects of lipid lowering therapy.Methods: Baseline CIMT studies of subjects with known heart disease, or high risk for heart disease, were evaluated from a single site of the Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies in Atherosclerosis trial (N=120. One sonographer obtained four views of the right and left far wall common CIMT, using a 13 MHz ultrasound probe. Images were blindly reviewed for the presence of the TLP. The TLP was defined as absent (0, possible (1, or definite (2. A composite score from all four views was calculated. A patient was defined as having the TLP if the composite score was ≥4. Univariate predictors of the TLP were explored. Follow-up ultrasounds at 14 months were also reviewed for presence of the TLP.Results: The prevalence of the TLP at baseline was 22.5%. Among cardiovascular risk variables, systolic blood pressure was significantly higher in subjects displaying the TLP (141.3±15.6 mmHg versus 133.1±18.4 mmHg; P=0.036. There were no differences among those with, and without, the TLP, with respect to other cardiovascular risk variables (age, sex, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, C-reactive protein, glucose, weight, waist girth, tobacco use, medications, quantitative CIMT, or image quality. During ongoing lipid lowering therapy, the prevalence of the TLP increased to 54

  2. Effect of Short term intensive multitherapy on Carotid intima-media thickness in patients with newly diagnosed type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    GUO Li-xin; PAN Qi; WANG Xiao-xia; LI Hui; ZHANG Li-na; CHI Jia-min; WANG Yao

    2008-01-01

    Background Controlling plasma glucose levels, blood pressure and lipid levels is proven to reduce the risk of vascular complications in patients with type 2 diabetes mellitus. This has prompted intensive multitherapy targeted at several macrovascular risk factors.Carotid intima-media thickness(cIMT)is a reliable measure of early atherosclerosis. We sought to determine whether a 6-month intensive mutiltherapy program resulted in better goal attainment than usual care and its effect on the development of cIMT among patients with newly diagnosed type 2 diabetes mellitus. Methods The study randomly assigned 220 patients with newly diagnosed type 2 diabetes mellitus to intensive or traditional therapy groups. The clinical parameters, such as fasting plasma glucose, total cholesterol, triglyceride, blood pressure, body weight and insulin were assessed at the baseline and after the 6-month therapy. cIMT of the patients wasalso obtained. Results The average levels of fasting plasma glucose, hemoglobin A1c, total cholesterol (TC)and low-density lipoprotein cholesterol (LDL-C)in the intensive group were significantly lower than those in the control group at the end of 6-month treatment. By 6 months, a higher proportion of patients in the intensive therapy group than in the control group attained goals for fasting plasma glucose(FPG), TC, LDL-C and hemoglobin A1c.With intensive multherapy the level of carotid intima-media thickness in the intensive therapy group was lower than that in the control group((0.88±0.26)mm vs(0.96±0.22)mm, P<0.01).Conclusions The evidence from this clinical trial demonstrates that intensive glucose. lipid and blood pressure control in patients with newly diagnosed type 2 diabetes is associated with diabetic macrovascular benefits. Intensive multitherapy allows more patients to achieve aims of control and may reduce macrovascular complications and delay disease progression.

  3. Carotid Intima-media Thickness Measurements: Relations with Atherosclerosis, Risk of Cardiovascular Disease and Application in Randomized Controlled Trials.

    Science.gov (United States)

    Bots, Michiel L; Evans, Gregory W; Tegeler, Charles H; Meijer, Rudy

    2016-01-20

    Advances in the field of carotid ultrasound have been incremental, resulting in a steady decrease in measurement variability. Improvements in edge detection algorithms point toward increasing automation of CIMT measurements. The major advantage of CIMT is that it is completely noninvasive and can be repeated as often as required. It provides a continuous measure since all subjects have a measurable carotid wall. It is also relatively inexpensive to perform, and the technology is widely available. A graded relation between raising LDL cholesterol and increased CIMT is apparent. Increased CIMT has been shown consistently to relate the atherosclerotic abnormalities elsewhere in the arterial system. Moreover, increased CIMT predicts future vascular events in both populations from Caucasian ancestry and those from Asian ancestry. Furthermore, lipid‑lowering therapy has been shown to affect CIMT progression within 12–18 months in properly designed trials with results congruent with clinical events trials. In conclusion, when one wants to evaluate the effect of a pharmaceutical intervention that is to be expected to beneficially affect atherosclerosis progression and to reduce CV event risk, the use of CIMT measurements over time is a valid, suitable, and evidence‑based choice.

  4. Carotid intima-media thickness measurement in ultrasound image based on deep learning%基于深度学习的颈动脉超声图像内中膜厚度测量

    Institute of Scientific and Technical Information of China (English)

    孙萍; 李锵; 关欣; 滕建辅

    2016-01-01

    Objective The common carotid artery intima-media thickness (IMT) is a widely accepted and important marker of early atherosclerosis,and measurement of IMT based on manual tracing is time-consuming and complicated.A fully automatic segmentation (AS) method was proposed in this study for the IMT measurement to overcome the drawbacks.Methods First,convolutional neural network (CNN) was applied to identify carotid artery distal and region of interest (ROI) was extracted,which included intima-media complex (IMC).The pattern classifier based on the stacked auto encoder (SAE) was added to classify pixels of ROI.Reliable classification regions were chosen based on region area and region center,and the IMT measurement was completed by extracting final boundary with the method of curve fitting.A total of 84 ultrasound images from 84 corresponding patients were tested with the proposed method.The ground truth (GT) of IMT was manually measured for four times by two experts and then averaged,and the automatic segmented IMT was computed using the proposed method.Results The mean of the absolute error and standard deviation between AS and GT IMT was (13.3±20.5) μm,and the correlation coefficient was 0.990 7.Conclusions Experimental results show that the over all performance of the proposed method is better,and it can achieve automatic,fast and accurate segmentation of intima-media of common carotid artery,which satisfy the clinical requirements.%目的 颈动脉血管内中膜厚度(IMT)是衡量动脉粥样硬化程度的重要标准.一般采用人工标定进行测量,该过程耗时且繁琐,由此提出一种总体性能较好的全自动分割(AS)算法.方法 该算法首先利用卷积神经网络(CNN)识别出颈动脉血管远端,进而提取包含颈动脉内膜、中膜部分的感兴趣区域(ROI).采用基于堆栈式自编码器(SAE)构造的模式分类器将ROI中的像素进行分类.最后利用分类区域的面积信息和位置信息对分类结果进行

  5. Prediction of progression of ultrasound assessed carotid artery athersclerosis

    OpenAIRE

    2014-01-01

    Atherosclerosis is an important underlying cause of cardiovascular disease and death. According to the World Health Organization’s Global Burden of Disease Study, ischemic heart disease and stroke combined killed 12.9 million people in 2010, or one in four deaths worldwide. Ultrasound of the carotid arteries can be used to assess the burden of atherosclerosis by measurements of intima-media thickness (IMT) and total plaque area (TPA). Age, male gender, serum cholesterol, blood pressure and...

  6. The Relationship Between Increased Epicardial Fat Thickness and Left Ventricular Hypertrophy and Carotid Intima-Media Thickness in Patients With Nonfunctional Adrenal Incidentaloma

    Directory of Open Access Journals (Sweden)

    Imga

    2016-07-01

    Full Text Available Background Emerging evidences indicate that patients diagnosed with Adrenal Incidentaloma (AI may present cardiovascular complications. Epicardial fat thickness (EFT has recently been described as a new risk factor and an active player in metabolic syndrome and cardiovascular disease. Objectives We aimed to evaluate the relationship between EFT and left ventricular hypertrophy and carotid intima-media thickness, which are both strong predictors of cardiovascular morbity and mortality, in patients with nonfunctioning AI. Patients and Methods We evaluated 51 patients (36 females and 15 males diagnosed with AI and 35 (29 females, 6 males age, gender and body mass index (BMI matched healthy controls in terms of cardiovascular risk parameters. Epicardial fat was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium. Results Epicardial fat thickness was significantly higher in patients with AI when compared to the control group (0.89 ± 0.32 cm vs. 0.74 ± 0.26 cm; P = 0.023. left ventricular (LV mass index and median carotid intima-media thickness (CIMT were also higher in subjects with AI than in controls (99.8 g/m2 vs. 86.9 g/m2; P = 0.024 and 7.5 mm (5.5 - 11.5 vs. 6.5 mm (4.5 - 9.5; P = 0.017. There was a positive correlation between EFT, LV mass index, EFT and CIMT (r = 0.315, P = 0.004; r = 0.363, P < 0.001; respectively. Conclusions In this study we showed that EFT, measured by echocardiography is higher in subjects with AI when compared to healthy controls. epicardial fat thickness had the best independent correlation with AI in multiple logistic regression analysis. Incidentaloma is also associated with increased left ventricular mass index and CIMT. Adrenal incidentaloma patients may show early cardiac changes, such as increased left ventricular mass and increased CIMT.

  7. The Value of Measurement of Carotid Intima-media Thickness Using Ultrasound in Patients with Cardio-cerebro-vascular Diseases%超声检测颈动脉内中膜厚度在心脑血管疾病中的价值

    Institute of Scientific and Technical Information of China (English)

    刘志敏; 黄碧霞; 古泉辉

    2013-01-01

    Objective:To study the value of measurement of carotid intima-media thickness using ultrasound in cardio-cerebro-vascular diseases. Method:Patients associated with hypertension,diabetes,coronary heart disease,cerebral infarction from our hospital from August 2012 to April 2013 were recruited.Color Doppler ultrasound was used to measure their carotid intima-media thickness(IMT) as well as artery atheromatous plague and stenosis of carotid artery.Result:(1)An average of 58%of patients indicated having abnormities of carotid intima media thickness when 52%and 9%of them having carotid artery atheromatous plague and stenosis of carotid artery respectively.(2)Patients with anomaly of carotid intima media thickness had significantly higher rates of hypertension and cerebral infarction.Conclusion:Noninvasive measurement of carotid intima-media thickness using Color Doppler ultrasound is a effective and convenient technique of screening and assessment for atherosclerosis among patients.It will be helpful for cohort at high risk of atherosclerosis and for diagnosis and treatment of this disease.%目的:探讨超声测量颈总动脉内-中膜厚度(IMT)在心脑血管疾病中的价值。方法:2012年8月-2013年4月来笔者所在医院就诊的高血压、糖尿病、冠心病、脑梗死患者均经高分辨率彩色多普勒超声检测双侧颈动脉内中膜厚度(IMT)、斑块有无及性质、管腔狭窄程度。结果:(1)颈动脉IMT异常者占58%,颈动脉斑块阳性者占52%,颈动脉狭窄者占9%,以轻度狭窄为主。(2)颈动脉内中膜检测有阳性的病变者中,高血压与脑梗死患者的检出率较高。结论:采用高分辨率彩色多普勒超声检测颈动脉内中膜厚度的方法,对筛查和评估动脉粥样硬化疾病,是一种简便、经济、有效、无创、可测量、重复性好的科学手段;也可以对无临床症状的高危人群的预后提供帮助;为早期临床诊断及干预动脉硬化提供依据。

  8. An investigation of two-dimensional ultrasound carotid plaque presence and intima media thickness in middle-aged South Asian and European men living in the United kingdom.

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    Nazim Ghouri

    Full Text Available Ultrasound studies of carotid intima media thickness (cIMT and plaques are limited in South Asians, a group at elevated cardiovascular disease (CVD risk. We determined whether South Asians have a difference in these ultrasound markers compared to Europeans living in the United Kingdom and whether measured risk factor(s could account for any such differences.One hundred South Asian men, aged 40 to 70 years and 100 European men of similar age and BMI, without diagnosed CVD or diabetes, underwent carotid ultrasound for measurement of cIMT and carotid plaque presence. Physical activity, cardiorespiratory fitness, anthropometry and blood pressure were assessed, fasted blood taken for measurement of cardiometabolic risk factors and demographic and lifestyle factors recorded.Age-adjusted mean (SD cIMT was similar in South Asians and Europeans (0.64 (0.16 mm v 0.65 (0.12 mm, p = 0.64. Plaque was present in 48 South Asians and 37 Europeans and overall, there was no age-adjusted difference between South Asian and Europeans for plaque score(odds ratio 1.49, 95% CI, 0.86-2.80, p = 0.16, however, South Asians appeared to have more plaques at a younger age than Europeans; at age 40-50 years the odds of South Asians having plaques was 2.63 (95% CI, 1.16-5.93 times that for Europeans.cIMT is similar between healthy South Asian and European men. Whilst there was no overall difference in plaque presence in South Asians, there is an indication of greater plaque prevalence at younger ages--an observation requiring further investigation. Prospective studies linking plaques to CVD outcomes in South Asians are needed to investigate whether these measures help improve CVD risk prediction.

  9. The association of carotid intima media thickness with retinol binding protein-4 and total and high molecular weight adiponectin in type 2 diabetic patients

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    Mansouri Masoumeh

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to investigate whether carotid intima media thickness (CIMT is associated with serum level of retinol- binding protein-4 (RBP4 and total and high molecular weight (HMW adiponectin in type 2 diabetes (T2DM without clinical symptom of atherosclerotic disease. Method 101 type 2 diabetic patients (mean age, 53.63 ± 8.42 years and 42 body mass index (BMI matched control (mean age 50.1 ± 8.4 were recruited. The CIMT was assessed by using B-mode ultrasonography, while serum levels of RBP4 and total and HMW adiponectin were measured by using enzyme linked immunosorbant assay (ELISA. Linear regression analysis was performed with CIMT as dependent variable and adipokines and cardio metabolic risk factors as independent variables. Result The CIMT was higher in diabetic group compared to control group (p Age (B = 0.44 P Conclusion In conclusion, the present study showed that serum levels of RBP4 or total and HMW adiponectin were not potential predictors of CIMT in type 2 diabetic patients who exposed to this risk factor at least for nine years.

  10. Effects of Ramipril and Telmisartan on Plasma Concentrations of Low Molecular Weight and Protein Thiols and Carotid Intima Media Thickness in Patients with Chronic Kidney Disease

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    Angelo Zinellu

    2016-01-01

    Full Text Available Hypertension, a common feature in chronic kidney disease (CKD, is an independent risk factor for CKD progression and cardiovascular disease. Although inhibitors of the renin-angiotensin system (RAS exert salutary effects on blood pressure control and proteinuria in CKD patients, their activity towards traditional and novel oxidative markers is largely unknown. We studied the effects of 6-month treatment with telmisartan versus a combination of telmisartan and ramipril on plasma concentrations of low molecular mass (LMW, including homocysteine and cysteine and protein thiols (PSH plasma concentration and their relationships with carotid intima media thickness (IMT, in 24 hypertensive CKD patients (age 60±12 years, 8 females and 16 males. Pretreatment PSH concentrations were independently associated with IMT (r=-0.42, p=0.039. Neither treatment affected plasma LMW thiols, in both reduced and total form. By contrast, both treatments increased PSH plasma concentrations and reduced IMT, although significant differences were only observed in the combined treatment group. Our results suggest that the beneficial effects of combined RAS inhibitor treatment on IMT in hypertensive CKD patients may be mediated by a reduction of oxidative stress markers, particularly PSH.

  11. Kallistatin as a marker of microvascular complications in children and adolescents with type 1 diabetes mellitus: Relation to carotid intima media thickness.

    Science.gov (United States)

    El-Asrar, Mohamed A; Andrawes, Nevine G; Ismail, Eman A; Salem, Shaimaa Mh

    2015-12-01

    In diabetes, angiogenesis is disturbed, contributing to proliferative retinopathy, nephropathy and neuropathy. Kallistatin, a serine proteinase inhibitor, has anti-angiogenic effects. We assessed serum kallistatin in children and adolescents with type 1 diabetes as a potential marker for microvascular complications and its relation to carotid intima media thickness (CIMT). Sixty patients with type 1 diabetes were divided into two groups according to the presence of microvascular complications and compared with 30 healthy controls. High-sensitivity C-reactive protein (hs-CRP), HbA1c, urinary albumin creatinine ratio (UACR), kallistatin levels and CIMT were assessed. Kallistatin levels were significantly higher in patients with microvascular complications (9.9 ± 2.38 ng/mL) and those without complications (5.0 ± 1.5 ng/mL) than in healthy controls (1.39 ± 0.55 ng/mL; pgroup (pblood glucose, HbA1c, triglycerides, total cholesterol, hs-CRP, UACR and CIMT (pdiabetes and its relation with CIMT may reflect vascular dysfunction and suggest a link between micro- and macro-angiopathy.

  12. The effects of vitamin D, K and calcium co-supplementation on carotid intima-media thickness and metabolic status in overweight type 2 diabetic patients with CHD.

    Science.gov (United States)

    Asemi, Zatollah; Raygan, Fariba; Bahmani, Fereshteh; Rezavandi, Zohreh; Talari, Hamid Reza; Rafiee, Motahereh; Poladchang, Somayyeh; Darooghegi Mofrad, Manijeh; Taheri, Sara; Mohammadi, Ali Akbar; Esmaillzadeh, Ahmad

    2016-07-01

    This study was conducted to examine the effects of vitamin D, K and Ca co-supplementation on carotid intima-media thickness (CIMT) and metabolic status in overweight diabetic patients with CHD. This randomised, double-blind, placebo-controlled trial was conducted among sixty-six diabetic patients with CHD. Participants were randomly allocated into two groups to take either 5µg vitamin D, 90 µg vitamin K plus 500 mg Ca supplements (n 33) or placebo (n 33) twice a day for 12 weeks. Fasting blood samples were obtained at the beginning of the study and after the 12-week intervention period to determine related markers. Vitamin D, K and Ca co-supplementation resulted in a significant reduction in maximum levels of left CIMT (-0·04 (sd 0·22) v. +0·04 (sd 0·09) mm, P=0·02). Changes in serum vitamin D (+6·5 (sd 7·8) v. +0·4 (sd 2·2) ng/ml, Pvitamin D, K and Ca co-supplementation for 12 weeks among diabetic patients with CHD had beneficial effects on maximum levels of left CIMT and metabolic status. The effect of vitamin D, K and Ca co-supplementation on maximum levels of left CIMT could be a chance finding.

  13. Rate of change in carotid intima-media thickness and vascular events: meta-analyses can not solve all the issues. A point of view.

    Science.gov (United States)

    Bots, Michiel L; Taylor, Allen J; Kastelein, John J P; Peters, Sanne A E; den Ruijter, Hester M; Tegeler, Charles H; Baldassarre, Damiano; Stein, James H; O'Leary, Daniel H; Revkin, James H; Grobbee, Diederick E

    2012-09-01

    Whether a change in the rate of carotid intima-media thickness (CIMT) over time that is induced by a pharmaceutical intervention can be directly translated into change in future cardiovascular disease risk is an important issue. As this biomarker is increasingly used as primary outcome in many trials of the evaluation of novel cardiovascular treatments, this has become an important topic in cardiovascular drug development. Two recent meta-analyses using aggregated data from publication have attempted to address the issue. In our view both analyses suffer from considerable flaws. Flaws include the misuse of the concept of the atherosclerosis, pooling of trials carried out with treatments of heterogeneous efficacy and in patients, who had very different risk profiles; pooling of measurements from a wide variety of methodologies that shared a common name, 'CIMT'; lack of power for detecting relationships using meta-regression techniques, and lastly, the ecologic fallacy. In this article, we discuss the concerns in more detail and offer strategies to get a valid answer on whether therapy-induced change in CIMT indeed relates to change in vascular risk.

  14. Effect of intensive multifactorial treatment on the intima-media thickness of large arteries in patients with new-onset type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Xiao-hong ZHAO; Zhe-rong XU; Qin ZHANG; Hai-feng GU; Yun-mei YANG

    2012-01-01

    Objective:To quantify the changes in blood glucose,blood lipids,blood pressure,and the intima-media thickness (IMT) of large arteries in patients with new-onset type 2 diabetes mellitus who received either intensive multifactorial treatment or conventional treatment.Methods:Two-hundred and ten patients with new-onset type 2 diabetes mellitus were randomly assigned to two groups:an intensive treatment group (n=110) and a conventional treatment group (n=100).Fasting blood glucose (FBG),glycosylated hemoglobin A1c (HbA1c),blood pressure,blood lipids [total cholesterol (TC),triolyceride (TG),low-density lipoprotein C (LDL-C),and high-density lipoprotein C (HDL-C)],and IMTs of large arteries (carotid,iliac,and femoral arteries) were determined before and at one and two years after starting treatment.The patients in the conventional treatment group received routine diabetes management in our outpatient department.Targets were established for patients in the intensive treatment group.Their blood glucose,blood lipids,and blood pressure levels were regularly monitored and therapeutic regimens were adjusted for those whose measurements did not meet the target values until all the parameters met the established targets.Within-group and between-group differences were evaluated.Results:A significantly greater percentage of patients in the intensive treatment group had LDL-C levels that reached the target value one year after starting treatment than those in the conventional treatment group (52.04% vs.33.33%,P<0.05).No significant differences were found between groups for FBG,HbA1c,blood pressure,TG,TC,or HDL-C.The percentages of patients with TG (51.02% vs.34.48%),TC (52.04% vs.33.33%),and LDL-C (61.22% vs.43.67%) who met the respective target values in the intensive treatment group were all significantly higher than the corresponding percentages in the conventional treatment group two years after starting treatment (P<0.05).There were no significant

  15. The estimated GFR, but not the stage of diabetic nephropathy graded by the urinary albumin excretion, is associated with the carotid intima-media thickness in patients with type 2 diabetes mellitus: a cross-sectional study

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    Ishida Hidenori

    2010-05-01

    Full Text Available Abstract Background To study the relationship between the intima-media thickness (IMT of the carotid artery and the stage of chronic kidney disease (CKD based on the estimated glomerular filtration rate (eGFR and diabetic nephropathy graded by the urinary albumin excretion (UAE in the patients with type 2 diabetes mellitus. Methods A cross-sectional study was performed in 338 patients with type 2 diabetes mellitus. The carotid IMT was measured using an ultrasonographic examination. Results The mean carotid IMT was 1.06 ± 0.27 mm, and 42% of the subjects showed IMT thickening (≥ 1.1 mm. Cerebrovascular disease and coronary heart disease were frequent in the patients with IMT thickening. The carotid IMT elevated significantly with the stage progression of CKD (0.87 ± 0.19 mm in stage 1, 1.02 ± 0.26 mm in stage 2, 1.11 ± 0.26 mm in stage 3, and 1.11 ± 0.27 mm in stage 4+5. However, the IMT was not significantly different among the various stages of diabetic nephropathy. The IMT was significantly greater in the diabetic patients with hypertension compared to those without hypertension. The IMT positively correlated with the age, the duration of diabetes mellitus, and the brachial-ankle pulse wave velocities (baPWV, and negatively correlated with the eGFR. In a stepwise multivariate regression analysis, the eGFR and the baPWV were independently associated with the carotid IMT. Conclusions Our study is the first report showing a relationship between the carotid IMT and the renal parameters including eGFR and the stages of diabetic nephropathy with a confirmed association between the IMT and diabetic macroangiopathy. Our study further confirms the importance of intensive examinations for the early detection of atherosclerosis and positive treatments for hypertension, dyslipidaemia, obesity, as well as hyperglycaemia are necessary when a reduced eGFR is found in diabetic patients.

  16. Association of Cardiovascular Risk Factors with Carotid Intima Media Thickness in Patients with Rheumatoid Arthritis with Low Disease Activity Compared to Controls: A Cross-Sectional Study.

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    Deborah F van Breukelen-van der Stoep

    Full Text Available Rheumatoid arthritis (RA has been identified as an independent cardiovascular risk factor. The importance of risk factors such as hypertension and hyperlipidemia in the generation of atherosclerosis in RA patients is unclear. This study analyzed clinical parameters associated with carotid intima media thickness (cIMT in patients with RA.Subjects with RA and healthy controls without RA, both without known cardiovascular disease, were included. Participants underwent a standard physical examination and laboratory measurements including a lipid profile. cIMT was measured semi-automatically by ultrasound.In total 243 RA patients and 117 controls were included. The median RA disease duration was 7 years (IQR 2-14 years. The median DAS28 was 2.4 (IQR 1.6-3.2 and 114 (50.4% of the RA patients were in remission. The presence of RA and cIMT were not associated (univariate analysis. Multivariable regression analysis showed that cIMT in RA patients was associated with age (B = 0.006, P<0.001 and systolic blood pressure (B = 0.003, P = 0.003. In controls, cIMT was associated with age (B = 0.006, P<0.001 and smoking (B = 0.097, P = 0.001.cIMT values were similar between RA patients and controls. Hypertension was strongly associated with cIMT in RA patients. After adjustment, no association between cIMT and specific RA disease characteristics was found in this well treated RA cohort.

  17. Both serum apolipoprotein B and the apolipoprotein B/apolipoprotein A-I ratio are associated with carotid intima-media thickness.

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    Fei Huang

    Full Text Available BACKGROUND: Previous studies indicated that apolipoprotein measurements predicted cardiovascular disease (CVD risk; however, associations between apolipoproteins and carotid intima-media thickness (CIMT were less explored. METHODOLOGY AND PRINCIPAL FINDINGS: The cross-sectional study included 6069 participants aged 40 years or older with NGT from Shanghai, China. Serum fasting traditional lipids (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C] and triglycerides [TG], apoA-I and apoB were assessed. A high-resolution B-mode ultrasonography was performed to measure CIMT. We found CIMT increased progressively across the quartiles of serum apoB (p for trend <0.0001. In logistic regression, concentrations of apoB (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.18-1.36, TC (OR 1.23, 95% CI 1.14-1.32, LDL-C (OR 1.25, 95% CI 1.16-1.34 and TG (OR 1.11, 95% CI 1.04-1.20 were significantly related to elevated CIMT after adjusted for age and sex. Meanwhile, the apoB/apoA-I ratio (OR 1.25, 95% CI 1.17-1.34 related to elevated CIMT. ApoB (OR 1.23, 95% CI 1.00-1.51 and the apoB/apoA-I ratio (OR 1.19, 95% CI 1.04-1.36 remained significantly associated with elevated CIMT, after adjusted for the traditional CVD risk factors including traditional lipids. CONCLUSIONS AND SIGNIFICANCE: There were significant associations between serum apoB, the apoB/apoA-I ratio and elevated CIMT. Serum apoB and the apoB/apoA-I ratio might be independent predictors of early atherosclerosis in NGT.

  18. Genetic polymorphisms in the CD14 gene are associated with monocyte activation and carotid intima-media thickness in HIV-infected patients on antiretroviral therapy.

    Science.gov (United States)

    Yong, Yean K; Shankar, Esaki M; Westhorpe, Clare L V; Maisa, Anna; Spelman, Tim; Kamarulzaman, Adeeba; Crowe, Suzanne M; Lewin, Sharon R

    2016-08-01

    HIV-infected individuals on antiretroviral therapy (ART) are at increased risk of cardiovascular disease (CVD). Given the relationship between innate immune activation and CVD, we investigated the association of single-nucleotide polymorphisms (SNPs) in TLR4 and CD14 and carotid intima-media thickness (cIMT), a surrogate measurement for CVD, in HIV-infected individuals on ART and HIV-uninfected controls as a cross-sectional, case-control study. We quantified the frequency of monocyte subsets (CD14, CD16), markers of monocyte activation (CD38, HLA-DR), and endothelial adhesion (CCR2, CX3CR1, CD11b) by flow cytometry. Plasma levels of lipopolysaccharide, sCD163, sCD14, sCX3CL1, and sCCL2, were measured by ELISA. Genotyping of TLR4 and CD14 SNPs was also performed. The TT genotype for CD14/-260SNP but not the CC/CT genotype was associated with elevated plasma sCD14, and increased frequency of CD11b+CD14+ monocytes in HIV-infected individuals. The TT genotype was associated with lower cIMT in HIV-infected patients (n = 47) but not in HIV-uninfected controls (n = 37). The AG genotype for TLR4/+896 was associated with increased CX3CR1 expression on total monocytes among HIV-infected individuals and increased sCCL2 and fibrinogen levels in HIV-uninfected controls. SNPs in CD14/-260 and TLR4/+896 were significantly associated with different markers of systemic and monocyte activation and cIMT that differed between HIV-infected participants on ART and HIV-uninfected controls. Further investigation on the relationship of these SNPs with a clinical endpoint of CVD is warranted in HIV-infected patients on ART.

  19. Associations between blood glucose and carotid intima-media thickness disappear after adjustment for shared risk factors: the KORA F4 study.

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    Bernd Kowall

    Full Text Available OBJECTIVE: The association between blood glucose and carotid intima-media thickness (CIMT is considered to be established knowledge. We aimed to assess whether associations between different measures of glycaemia and CIMT are actually independent of anthropometric variables and metabolic risk factors. Moreover, we checked published studies for the adjustment for shared risk factors of blood glucose and CIMT. METHODS: Fasting glucose, 2-hour glucose, HbA1c, and CIMT were measured in 31-81-years-old participants of the population-based Cooperative Health Research in the Region of Augsburg (KORA F4 study in Southern Germany (n = 2,663. CIMT was assessed according to the Rotterdam protocol. Linear and logistic regression models with adjustment for age, sex, anthropometric measures, hypertension, and dyslipidaemia were fitted to assess the association between continuous measures of glycaemia, and categories of glucose regulation, respectively, with CIMT. RESULTS: We found a 0.10 mm increase (95%-confidence interval: 0.08-0.12 in CIMT in subjects with compared to subjects without diabetes in crude analysis. This increase was not significant in age-sex adjusted models (p = 0.17. Likewise, neither impaired fasting glucose (p = 0.22 nor impaired glucose tolerance (p = 0.93 were associated with CIMT after adjustment for age, sex, and waist circumference. In multivariable adjusted models, age, sex, hypertension, waist circumference, HDL and LDL cholesterol, but neither fasting glucose nor 2-hour glucose nor HbA1c were associated with elevated CIMT. Literature findings are inconclusive regarding an independent association of glucose levels and CIMT. CONCLUSION: CIMT is highly dependent on traditional cardiovascular risk factors, but no relationships between blood glucose and CIMT were found after adjustment for age, sex, and anthropometric variables.

  20. Correlation of E-selectin concentrations with carotid intima-media thickness and cardio-metabolic profile of mixed ancestry South Africans: a cross-sectional study.

    Science.gov (United States)

    Zemlin, Annalise E; Matsha, Tandi E; Kengne, Andre P; Hon, Gloudina M; Erasmus, Rajiv T

    2017-01-01

    Background E-selectin, an adhesion molecule, is a specific marker of endothelial dysfunction. High concentrations have been reported in type 2 diabetes and disorders with high risk of cardiovascular disease (CVD). Measurement of carotid intima-media thickness (CIMT) is a surrogate marker of early atherosclerosis. We examined the relationship between E-selectin concentrations, CIMT and cardio-metabolic traits in normo- and hyperglycaemic mixed ancestry South Africans. Methods E-selectin concentrations were determined in 308 subjects from the Cape Town Bellville South Community-based study on a mixed ancestry population. Their correlation with CIMT and cardio-metabolic profile used robust correlations and linear regression models. Results E-selectin concentrations were significantly higher in the hyperglycaemic (median 139.8 µg/L) compared to the normoglycaemic group (median 118.8 µg/L), ( p = 0.0007). Significant differences between the two groups were found for markers of glycaemia and adiposity, but not for CIMT. Significant correlations were found between E-selectin and age, markers of glycaemia and inflammation, central obesity and lipid variables. Associations remained significant only with age, hyperglycaemia and C-reactive protein in robust linear regression models. In similar regressions models, age and gender were the main predictors of CIMT, which was not associated with E-selectin. Conclusions E-selectin concentrations in this study were associated with hyperglycaemia, possibly reflecting early endothelial damage. However, E-selectin was not useful to assess CIMT, a marker of subclinical atherosclerosis, which appeared to be determined by ageing and male gender.

  1. Plasma cholesteryl ester transfer is a determinant of intima-media thickness in type 2 diabetic and nondiabetic subjects : Role of CETP and triglycerides

    NARCIS (Netherlands)

    de Vries, R; Perton, FG; Dallinga-Thie, GM; van Roon, AM; Wolffenbuttel, BHR; van Tol, A; Dullaart, RPF

    2005-01-01

    We tested whether carotid artery intima-media thickness (IMT) is associated with plasma cholesteryl ester transfer (CET) and/or the plasma cholesteryl ester transfer protein (CETP) concentration in type 2 diabetic and control subjects. In 87 male and female subjects with type 2 diabetes (nonsmokers,

  2. Beta-cell function is associated with carotid intima-media thickness independently of insulin resistance in healthy individuals

    DEFF Research Database (Denmark)

    Roussel, Ronan; Natali, Andrea; Balkau, Beverley

    2016-01-01

    Objective: It is a common belief that early atherosclerosis in prediabetes is causally linked to endothelial insulin resistance. Another condition, a low insulin secretion, may be associated with insufficient insulin action on the vascular wall and consequently favor atherosclerosis. Our aim...... was to test this hypothesis in people without diabetes, taking into account the gold-standard measurement of insulin sensitivity, a major confounder in the relationship between insulin secretion and atherosclerosis. Methods: We studied the European Relationship between Insulin Sensitivity and Cardiovascular...... Risk cohort of 451 men and 593 women (44±8 years, mean±SD) who were free of diabetes, hypertension, dyslipidemia, and other known chronic or acute conditions. All underwent an oral glucose tolerance test, a euglycemic-hyperinsulinemic clamp (M/I measured insulin sensitivity), and B-mode carotid...

  3. Relationship between glycemic status and progression of carotid intima-media thickness during treatment with combined statin and extended-release niacin in ARBITER 2

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    Allen J Taylor

    2007-03-01

    Full Text Available Allen J Taylor, Daming Zhu, Lance E Sullenberger, Hyun J Lee, Jeannie K Lee, Karen A Grace Cardiology Service, Walter Reed Army Medical Center, Washington, DC, USA Background: We previously reported in a placebo-controlled study that extended-release niacin slowed the progression of carotid atherosclerosis when added to statin monotherapy. This analysis examines the relationship between glycemic status and the effects of niacin on common carotid intima-media thickness (CIMT and HDL cholesterol.Methods: Post-hoc, subgroup analysis of ARBITER 2, a randomized, placebo-controlled trial of once-daily extended-release niacin (1000 mg added to background statin therapy in 167 patients (mean age 67 years with known coronary heart disease. The primary analysis was a comparison of the primary endpoint, the change in CIMT, between participants with either normal glycemic status, diabetes mellitus (DM or the metabolic syndrome (MS.Results: Baseline cardiovascular risk variables were significantly worse in those with abnormal glycemic status, particularly among subjects with MS. Niacin increased HDL-C to a similar degree (~20% across normals, DM and MS. Placebo-treated patients had the greatest CIMT progression, regardless of glycemic status. The lowest progression rate was observed in niacin treated patients with normal glycemic status. Among all niacin treated subjects, there was a significant linear relationship between change in CIMT and change in HDL-C (r = –0.16; p = 0.05, which was of similar magnitude in subgroups with normal glycemic status (r = –0.23; p = 0.08 and DM (r = –0.22; p = 0.17. In those with MS, there was no relationship between changes in HDL and CIMT, (r = 0.11; p = 0.44, whereas blood glucose was positive correlated to change in CIMT (r = 0.30; p = 0.04. In multivariable linear models controlling for MS characteristics and blood glucose changes, only the change in HDL independently predicted change in CIMT.Conclusions: During

  4. Nonalcoholic Fatty Liver Disease is Associated with Increased Carotid Intima-Media Thickness in Type 1 Diabetic Patients

    Science.gov (United States)

    Zhang, Lei; Guo, Kaifeng; Lu, Junxi; Zhao, Fangya; Yu, Haoyong; Han, Junfeng; Bao, Yuqian; Chen, Haibing; Jia, Weiping

    2016-01-01

    A growing body of evidence suggests that NAFLD is associated with an increased risk of incident CVD events both in patients without diabetes and in those with type 2 diabetes (T2DM). However, no published data are available regarding the association between NAFLD and C-IMT in T1DM. A total of 722 patients (371 men) with T1DM were included in this cross-sectional study. The main outcome measures were detection of NAFLD, C-IMT and classical risk factors. The mean age of the subjects was 46.2 years, and 51.1% were male. The prevalence of NAFLD was 15.9%. NAFLD patients had a markedly greater C-IMT (0.81 ± 0.25 vs. 0.69 ± 0.18 mm; p < 0.001) and frequency of carotid plaque (28.9% vs. 16.9%; p < 0.05) than those without fatty liver. Moreover, the differences in C-IMT remained after adjusting for potential confounders. A stepwise linear regression analysis revealed that age (standardized β, 0.326; p < 0.001), NAFLD (standardized β, 0.151, p < 0.001), and hsCRP (standardized β, 0.115, p = 0.008) were independently associated with C-IMT in all subjects. Our data show NAFLD is associated with elevated C-IMT in T1DM independent of conventional cardiovascular disease risk factors. PMID:27226159

  5. Comparison of Carotid Intima-Media Thickness in Pediatric Patients with Metabolic Syndrome, Heterozygous Familial Hyperlipidemia and Normals

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    Arvind Vijayasarathi

    2014-01-01

    Full Text Available Background. Our goal was to compare the carotid intimal-medial thickness (CIMT of untreated pediatric patients with metabolic syndrome (MS, heterozygous familial hyperlipidemia (heFH, and MS+heFH against one another and against a control group consisting of healthy, normal body habitus children. Methods. Our population consisted of untreated pediatric patients (ages 5–20 yrs who had CIMT measured in a standardized manner. Results. Our population included 57 with MS, 23 with heFH, and 10 with MS+heFH. The control group consisted of 84 children of the same age range. Mean CIMT for the MS group was 469.8 μm (SD = 67, 443.8 μm (SD = 61 for the heFH group, 478.3 μm (SD = 70 for the MS+heFH group, and 423.2 μm (SD = 45 for the normal control group. Significance differences between groups occurred for heFH versus MS (P=0.022, heFH versus control (P=0.038, MS versus control (P=9.0E-10, and MS+heFH versus control (P=0.003. Analysis showed significant negative correlation between HDL and CIMT (r=-0.32,  P=0.03 but not for LDL, triglycerides, BP, waist circumference, or BMI. Conclusion. For pediatric patients, the thickest CIMT occurred for patients with MS alone or for those with MS+heFH. This indicates that MS, rather than just elevated LDL, accounts for more rapid thickening of CIMT in this population.

  6. Anti-TNF-Alpha-Adalimumab Therapy Is Associated with Persistent Improvement of Endothelial Function without Progression of Carotid Intima-Media Wall Thickness in Patients with Rheumatoid Arthritis Refractory to Conventional Therapy

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    Carlos Gonzalez-Juanatey

    2012-01-01

    Full Text Available To determine whether treatment with the anti-TNF-alpha blocker adalimumab yields persistent improvement of endothelial function and prevents from morphological progression of subclinical atherosclerosis in patients with rheumatoid arthritis (RA refractory to conventional therapy, a series of 34 consecutive RA patients, attending hospital outpatient clinics and who were switched from disease modifying antirheumatic drug therapy to anti-TNF-alpha-adalimumab treatment because of severe disease, were assessed by ultrasonography techniques before the onset of adalimumab therapy (at day 0 and then at day 14 and at month 12. Values of flow-mediated endothelium-dependent vasodilatation at day 14 and at month 12 were significantly higher (mean ± standard deviation (SD: 6.1±3.9%; median: 5.7% at day 14, and mean ± SD: 7.4±2.8%; median: 6.9% at month 12 than those obtained at day 0 (mean: 4.5±4.0%; median: 3.6%; P=0.03 and P<0.001, resp.. Endothelium-independent vasodilatation results did not significantly change compared with those obtained at day 0. No significant differences were observed when carotid artery intima-media wall thickness values obtained at month 12 (mean ± SD: 0.69±0.21 mm were compared with those found at day 0 (0.65±0.16 mm (P=0.3. In conclusion, anti-TNF-alpha-adalimumab therapy has beneficial effects on the development of the subclinical atherosclerosis disease in RA.

  7. 糖尿病患者甲襞微循环病变及其与颈动脉内-中膜厚度的相关性%Nailfold microcirculation lesion of diabetes and its correlation with the carotid artery intima-media

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    张鑫月; 贾振华; 常丽萍; 刘美之

    2015-01-01

    Objective To research the microangiopathy of diabetes and its correlation with the macrocirculation .Methods 78 cases of type 2 diabetes mellitus(T2DM)were divided into experimental and control groups and the nail fold microcirculation (NFM)of all the cases were tested.The patients of T2DM were divided into NFM≤median and NFM>median subgroups .The correlation between NFM and internal medial thickening(IMT)of carotid artery were analyzed.Results The scores of cross,deformed,ooze and bleeding,aggregation of red blood cells of experimental group were higher than those of control group .The frequence of IMT thicker of NFM>median subgroup was more than that of NFM≤median subgroup.Conclusions The main microcirculation changes of T2DM are cross,deformed,ooze and Bleeding,aggrega-tion of red blood cells .There is closely associated with microvascular and macrovascular in diabetic .%目的:探讨2型糖尿病患者微血管病变特征及其与大血管病变的相关性。方法将78例2型糖尿病患者设为试验组与40例正常对照组进行对比,分别进行甲襞微循环检测,分析2型糖尿病患者微血管病变特征;采用中位数法将糖尿病人按甲襞微循环总分( NFM )分为积分≤中位数( NFM≤median)和积分>中位数( NFM>median)两部分,分析其与颈动脉内-中膜厚度及斑块形成的相关性。结果试验组甲襞微循环的交叉、畸形、渗出、出血、红细胞聚集五项积分高于对照组;NFM>median患者颈动脉内-中膜增厚出现频次高于 NFM≤median患者( P<0.05);NFM>me-dian患者颈动脉斑块出现频次高于 NFM≤median患者( P<0.05)。结论2型糖尿病患者微循环病变主要表现为交叉、畸形、红细胞聚集、袢周渗出、出血;糖尿病患者微血管与大血管病变密切相关。

  8. Association between carotid intima-media thickness and adiponectin in participants without diabetes or cardiovascular disease of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

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    de Almeida-Pititto, Bianca; Ribeiro-Filho, Fernando Flexa; Santos, Itamar S; Lotufo, Paulo A; Bensenor, Isabela M; Ferreira, Sandra Rg

    2017-01-01

    Objective The study assessed the association of adiponectin concentration with carotid intima-media thickness (CIMT) in middle-aged participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) without diabetes or cardiovascular disease. Design Cross-sectional analyses. Methods A sample of 687 individuals (35-54 years old) without diabetes or cardiovascular disease was stratified into two categories according to CIMT (< or ≥ 75th percentile). Traditional risk factors, C-reactive protein and adiponectin values were compared between categories by Student's t-test and frequencies by chi-square test. In linear regression models, associations of CIMT with adiponectin, adjusted for adiposity, blood pressure, C-reactive protein and homeostasis model assessment-insulin resistance were tested. Mean CIMT values were compared across quartiles of adiponectin concentrations using analysis of variance. Results Three hundred and forty-one individuals (49.6%) were women and 130 (19.0%) had three traditional cardiovascular risk factors. Those with elevated CIMT (21.8%) had greater mean values of body mass index (26.2(3.8) vs. 27.7(4.0)kg/m(2), p < 0.001), waist circumference (86.9(10.1) vs. 90.1(10.8) cm, p = 0.001), systolic blood pressure (116.2(13.6) vs.121.2(16.1) mmHg, p < 0.001), homeostasis model assessment index (1.4(0.9-2.4) vs. 1.8(1.1-2.9), p = 0.011), C-reactive protein (1.2 (0.6-2.6) vs. 1.4(0.8-3.2) mg/l, p = 0.054) and adiponectin (9.9 (6.0-14.7) vs. 8.9 (5.3-13.8) µg/ml, p = 0.002) levels than the counterpart, while plasma glucose and lipids were not different between groups. In the adjusted model, blood pressure (directly) and adiponectin (inversely) persisted associated with high CIMT. Mean CIMT was greater in the first quartile of adiponectin when compared with the other three quartiles ( p = 0.019). Conclusions Lower adiponectin levels together with higher blood pressure were independently associated with

  9. HIV Infection Is Not Associated with Carotid Intima-Media Thickness in Brazil: A Cross-Sectional Analysis from the INI/ELSA-Brasil Study

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    Grinsztejn, Beatriz; da Fonseca, Maria de Jesus M.; Griep, Rosane Härter; Lotufo, Paulo; Bensenor, Isabela; Mill, José G.; Moreira, Rodrigo de C.; Moreira, Ronaldo I.; Friedman, Ruth K.; Santini-Oliveira, Marilia; Cardoso, Sandra W.; Veloso, Valdiléa G.; Chor, Dóra

    2016-01-01

    Background Carotid intima-media thickness (cIMT) has been used as an early marker of atherosclerotic disease in the general population. Recently its role among HIV-infected patients has been questioned. To date, no Brazilian study has compared cIMT in respect to HIV status. Methods We compared data from 535 patients actively followed in a prospective cohort in Rio de Janeiro (HIV group); 88 HIV-negative individuals who were nominated by patients (friend controls–FCs); and 10,943 participants of the ELSA-Brasil study. Linear regression models were used to study associations of the 3 groups and several covariables with cIMT. Propensity scores weighting (PSW) were also employed to balance data. Results Median thickness in mm (IQR) were 0.54 (0.49,0.62); 0.58 (0.52,0.68); and 0.57 (0.49,0.70), HIV, FCs and ELSA-Brasil groups, respectively (p-value<0.001). The best linear model chosen did not include the group variables, after adjusting for all the variables chosen, showing no difference of cIMT across groups. Similar results were obtained with PSW. Several traditional CVD risk factors were also significantly associated with cIMT: female gender, higher education and higher HDL were negatively associated while risk factors were older age, current/former smoker, AMI/stroke family history, CVD history, hypertension, DM, higher BMI and total cholesterol. Conclusions We show for the first time in a middle-income setting that cIMT, is not different in HIV-infected patients in Rio de Janeiro compared with 2 different groups of non-HIV-infected individuals. Traditional CVD risk factors are associated with this outcome. Our results point out that high standards of care and prevention for CVD risk factors should always be sought both in the HIV-infected and non-infected populations to prevent CVD-related events. PMID:27391355

  10. Intima-media thickness and pulse wave velocity in hypertensive adolescents.

    Science.gov (United States)

    Gil, Tae Young; Sung, Choi Youn; Shim, Sung Shine; Hong, Young Mi

    2008-02-01

    Increased intima-media thickness (IMT) and pulse wave velocity (PWV) are noninvasive markers of early arterial wall alteration and are more widely used in adult clinical research. We investigated whether IMT and PWV are useful predictors of cardiovascular risk in hypertensive adolescents. Fifteen hypertensive adolescents (13-18 yr old, systolic BP > or = 140 mmHg, diastolic BP > or = 90 mmHg) and seventeen normotensive subjects were included. Height, weight, obesity index, body mass index (BMI), and fat distribution were obtained from each group. Serum lipid, insulin, vitamine B12, folate, renin, aldosterone, angiotensin-converting enzyme (ACE), and homocysteine levels were compared. The carotid IMT and PWV were measured. Arterial wall compliance and distensibility were calculated with the equation. High systolic blood pressure significantly correlated with height, weight, BMI, obesity index, arm circumference, fat mass, and fat distribution. Hypertensive adolescents had significantly greater cIMT (carotid intima-media thickness) and lower elastic properties such as cross-sectional compliance and distensibility of the carotid artery. The carotid IMT significantly correlated with brachial-ankle PWV. In conclusion, the measurement of carotid IMT and brachial-ankle PWV might be useful to predict the development of atherosclerosis in hypertensive adolescents.

  11. Long-term use of first-line highly active antiretroviral therapy is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients

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    Haohui Zhu

    2014-09-01

    Full Text Available Objective: To evaluate whether or not highly active antiretroviral therapy is associated with carotid artery stiffness in human immunodeficiency virus-positive patients in Henan Province, China. Method: Fifty human immunodeficiency virus-positive patients with at least a 5-year history of highly active antiretroviral therapy use and 50 human immunodeficiency virus-positive patients without a history of highly active antiretroviral therapy use were enrolled in this study. Carotid artery intima-media thickness and stiffness were determined by quantitative inter-media thickness and quantitative artery stiffness, respectively. Results: No statistically significant difference in carotid artery intima-media thickness and stiffness was observed between groups. A significant association between human immunodeficiency virus infection time and carotid artery stiffness was observed, but no significant association between human immunodeficiency virus infection time and intima-media thickness was found. No significant association between intima-media thickness, stiffness, and CD4+ and CD8+ T-cell counts were observed. Conclusion: The first-line highly active antiretroviral therapy currently used in China is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients with good highly active antiretroviral therapy compliance. Human immunodeficiency virus may play a role in the development of atherosclerosis.

  12. The Clinical Significance of VEGF and carotid intima-media thickness in Obstructive sleep apnea syndrome%VEGF和IMT测定对OSAS的临床意义

    Institute of Scientific and Technical Information of China (English)

    李慧; 钟定; 李莉

    2012-01-01

    Objective To explore the relationship between Vascular endothelial growth factor ( VEGF ), carotid intima-media thickness ( IMT ) and Obstructive sleep apnea syndrome ( OSAS ). Methods 30 male OSAS patients and 25 cases of normal subjects were selected to conduct sleep apnea monitoring by polysomnography. The level of VEGF in plasma was measured and the carotid IMT was evaluated. Their differences and the correlation with sleep monitoring index were analyzed. Results Compared with the control group, the AHI, hypoxia time at night, VEGF and IMT in OSAS increased more obviously, while the Lowest oxygen saturation decreased more obviously, and the differences were statistically significant ( P <0. 05 ). The VEGF positively correlated with AHI, night hypoxia time ( P <0. 05 ), but negatively correlated with lowest oxygen saturation ( P <0. 05 ). Carotid IMT was positively correlated with AHI ( P <0. 05 ), and negatively correlation with lowest oxygen saturation ( P < 0. 05 ). Conclusion VEGF may play an important role in the pathogenesis of patients with OSAS, which provides new ideas for early prevention OSAS patients with cardiovascular complications.%目的 探讨血管内皮生长因子(VEGF)、颈动脉内膜中层厚度(IMT)与OSAS患者的关系.方法 选取男性OSAS患者30例和体检正常者25例进行多导睡眠监测,评估呼吸暂停低通气指数(AHI)、夜间缺氧时间、最低血氧饱和度差异.同时,检测外周血中的VEGF水平和颈动脉内膜中层厚度(IMT),并分析其差异及与睡眠监测指标相关性.结果 与对照组比较,OSAS患者呼吸暂停低通气指数(AHI)、夜间缺氧时间、IMT、VEGF较明显增高,最低血氧饱和度明显降低,差异有统计学意义(P均<0.05);相关性分析显示,血浆VEGF与AHI、夜间缺氧时间正相关(P<0.05),与最低血氧饱和度负相关(P<0.05).颈动脉IMT与AHI正相关(P<0.05),与最低血氧饱和度负相关(P<0.05).结论 VEGF可能在OSAS患者发病

  13. Border Detection of Common Carotid Artery Using Hough Transform

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    Koya, Yoshiharu; Nagahara, Yoshihiro

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. The arteriosclerosis of the common carotid artery is diagnosed using Intima-Media Thickness (IMT) which is obtained from echocardiogram. In order to measure IMT from echocardiogram, it is required to detect a border which is a boundary between vessel tissue layers. The method of border detection requires reproducibility and high accuracy. The conventional methods to detect the border curve depend on differential value of brightness on the common carotid artery. Therefore, we can't extract a good candidate point by influence of a noise. In this paper, we propose the high-accuracy detection method by Hough Transform. About high-accuracy, it realized by attaching importance to high reliable candidate point of border.

  14. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden: a cross sectional study using whole body magnetic resonance angiography.

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    Jonathan R Weir-McCall

    Full Text Available Common carotid intima media thickness (CIMT and ankle brachial pressure index (ABPI are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA.50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR. The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated.The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045, however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01 with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012, which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45, while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005.ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is

  15. ULTRASONOGRAPHIC ASSESSMENT OF COMMON CAROTID ARTERY ATHEROSCLEROSIS IN PATIENTS OF RHEUMATOID ARTHRITIS

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    Jayakumar

    2015-02-01

    Full Text Available BACKGROUND & OBJECTIVES: Patients with Rheumatoid Arthritis (R.A. have a marked increase in Carotid Atherosclerosis independent of traditional risk factors like family history of myocardial infarction in first degree male relatives younger than 55 years of age or first degree female relatives younger than 65 years of age, smoking, hypertension (D efined as blood pressure of 140/90 mm hg or higher, diabetes mellitus and fasting serum cholesterol levels including age. Chronic inflammation and possibly disease severity and duration are atherogenic in Rheumatoid Arthritis patients. Preclinical disease may also be identified by using ultrasonography to determine carotid intimal - media thickness, an indirect measure of atherosclerosis. The common carotid artery Intima media thickness in Rheumatoid Arthritis patients is positively associated with disease duration, Early Rheumatoid Arthritis (D uration less or = 1 year is associated with lesser Intima media thickness than was Rheumatoid Arthritis of longer duration. Increased carotid artery Intima media thickness and the presence of carotid plaque are associated with markers of systemic inflammation in patients with Rheumatoid Arthritis and in healthy subjects. OBJECTIVE OF THE STUDY: To determine preclinical atherosclerosis occurring prematurely in patients of Rheumatoid Arthritis by ultrasonograhic measurement Common Carotid Artery Intima media thickness and to evaluate the risk factors associated with arterial intima media thickness in patient of Rheumatoid Arthritis. RESULTS: In RA patients, common carotid artery IMT was significantly higher when compared to healthy controls (0.65 ± 0.06 v/s 0.57 ± 0.049 and was significantly associated with the duration of RA, swollen joint count and erosive changes on hand x - ray independently of other confounding variables. CONCLUSION: Patients with rheumatoid arthritis have a marked increase in carotid atherosclerosis independent of traditional risk factors

  16. Role of Vitamin D in Intima Media Thickness in Patients with Type 1 Diabetes Mellitus.

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    Taskiran, Bengur; Cansu, Guven B; Bahadir, Eylem; Mutluay, Ruya

    2017-01-01

    Increased carotid intima media thickness indicates subclinical atherosclerosis. We evaluated the relation between vitamin D level and intima media thickness in patients with type 1 DM. 93 patients (female/male: 48/45, aged 31.5 ± 11.9 years, A1c 9.48 ± 2.43, vitamin D [15.9 (12.1-19.2)]) with type 1 DM were included into the study. Common carotid artery IMT was measured by real time B mode ultrasonography (MyLab 70 XVG, Esaote SpA, Genoa, Italy). Vitamin D was measured using radioimmunassay. Male and female patients (n = 14, 15%) had similar rates of plaque presence (p = 0.377). IMT was similar according to gender. IMT [0.45 (0.40-0.50)] was positively correlated with age, duration of diabetes, creatinine, LDL/HDL ratio, and ALP. Median IMT was higher in current smokers, patients with retinopathy, and nephropathy, and overweight/obese patients. IMT was not different according to vitamin D status. However calcium level corrected for albumin was in positive correlation with mean IMT (r = 0.221, p = 0.033). We detected high frequency of vitamin D deficiency (78%) defined as less than 20 ng/ml. Vitamin D and diabetes control defined as A1c have no effect on intima media thickness in type 1 DM. Traditional cardiovascular risk factors including age, duration of DM, smoking, and BMI adversely affect intima media thickness.

  17. Novel markers of endothelial dysfunction and inflammation in Behçet's disease patients with ocular involvement: epicardial fat thickness, carotid intima media thickness, serum ADMA level, and neutrophil-to-lymphocyte ratio.

    Science.gov (United States)

    Yuksel, Murat; Yildiz, Abdulkadir; Oylumlu, Mustafa; Turkcu, Fatih Mehmet; Bilik, Mehmet Zihni; Ekinci, Aysun; Elbey, Bilal; Tekbas, Ebru; Alan, Sait

    2016-03-01

    The etiology of Behçet's disease (BD) has not been fully elucidated. However, immunological and environmental factors, endothelial dysfunction (ED), and genetic susceptibility have been proposed to play a role. In this study, we aimed to evaluate epicardial fat thickness (EFT) together with serum asymmetric dimethylarginine (ADMA), carotid intima media thickness (CIMT), and neutrophil-to-lymphocyte ratio (NLR) in BD patients with ocular involvement. Thirty-six ocular BD patients (17 active and 19 inactive ocular involvement), and 35 age and sex-matched healthy controls were enrolled to this cross-sectional study. All patients underwent examinations with transthoracic echocardiography and carotid Doppler ultrasound. Serum ADMA levels, CIMT, EFT, and NLR were compared between groups, and their association with disease activity was evaluated. Behçet's disease patients had higher WBC counts, neutrophil counts, NLR, CIMT, EFT values, and serum ADMA levels than do healthy controls. The other biochemical, hematological, and echocardiographic parameters were comparable between the two groups. Behçet's disease duration was positively correlated with EFT and CIMT. Multivariate logistic regression analysis revealed that increased serum ADMA concentration and CIMT are independently associated with BD. Neutrophil counts, NLR, and serum ADMA level were higher, and lymphocyte count was lower in patients with active ocular BD compared to those of inactive ocular BD group. Carotid intima media thickness, serum ADMA level, EFT, and NLR were increased in ocular BD patients compared to healthy subjects. In addition, both serum ADMA level and NLR were associated with disease activity of ocular involvement. Increase in disease duration was associated with increase in CIMT and EFT which suggests that anatomical changes occur in time during the disease course. Increased CIMT, serum ADMA level, EFT, and NLR may provide new clues about the role of ED and inflammation in the

  18. 老年人动态脉压及脉压指数与颈动脉内膜中层厚度的相关性分析%Relationship between ambulatory pulse pressure,pulse pressure index and carotid intima media thickness in old subjectss

    Institute of Scientific and Technical Information of China (English)

    何佳; 唐海沁

    2013-01-01

    目的 探讨老年人动态脉压及脉压指数与颈动脉内膜中层厚度的关系.方法 随机抽样调查65岁以上人群200人进行24h动态血压监测,监测患者的动态脉压(APP)水平,按APP≤40 mm Hg(46例)、41 ~60 mm Hg(66例)、61~80 mm Hg(61例)和>80 mm Hg(27例)分为4组;按动态脉压指数(APPI)≤0.40(49例)、0.41 ~0.50(70例)、0.51 ~0.60(57例)和>0.60(24例)分为4组.分别以彩色多普勒超声测定其颈动脉内膜中层厚度(IMT),并采集其静脉血测定血脂及高敏C-反应蛋白(hs-CRP).结果 随着APP及APPI的增加,颈动脉IMT明显增加,差异有统计学意义(P<0.05);Spearman相关分析,结果APP、APPI与颈动脉IMT呈正相关,其中以APPI相关系数(r)值大.结论 动态脉压及脉压指数与颈动脉内膜中层厚度密切相关,且脉压指数在一定程度上较脉压在动脉硬化发展上有更大相关性.%Objective To investigate the correlation of ambulatory pulse pressure (APP) and ambulatory pulse pressure index(APPI) with intima-media thickness(IMT) of carotid artery in old people.Methods To evaluate the value of APP and APPI within 24 hours in 200 senile patients chosen at random who are over 65 years old,whose PP and PPI level were measured by the dynamic blood pressure(BP) monitor.Those senile patients were divided into 4 groups based on APP level,as APP ≤ 40 mmHg(46 cases),41-60 mmHg(66 cases),61-80 mmHg(61 cases) and APP > 80 mmHg(27 cases).These cases were also further divided into 4 groups based on APPI level,as APPI≤0.40(49 cases),0.41-0.50(70 cases),0.51-0.60(57 cases),and APPI >0.60(24 cases).Intima-media thickness(IMT) of carotid artery,serum lipid and hs-CRP concentration were determined by Color Doppler Ultrasonography and immune turbidimetric assay,respectively.Results With the increase of APP and APPI,carotid IMT increased significantly,the difference was statistically significant (P < 0.05).Spearman correlation analysis showed that APP

  19. Data on carotid intima-media thickness and lipoprotein subclasses in type 1 diabetes from the Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC).

    Science.gov (United States)

    Basu, Arpita; Jenkins, Alicia J; Zhang, Ying; Stoner, Julie A; Klein, Richard L; Lopes-Virella, Maria F; Timothy Garvey, W; Lyons, Timothy J

    2016-03-01

    Type 1 diabetes (T1DM) is associated with increased risk of macrovascular complications. We examined longitudinal associations of serum conventional lipids and nuclear magnetic resonance (NMR)-determined lipoprotein subclasses with carotid intima-media thickness (IMT) in adults with T1DM (n=455) enrolled in the Diabetes Control and Complications Trial (DCCT). Data on serum lipids and lipoproteins were collected at DCCT baseline (1983-89) and were correlated with common and internal carotid IMT determined by ultrasonography during the observational follow-up of the DCCT, the Epidemiology of Diabetes Interventions and Complications (EDIC) study, at EDIC 'Year 1' (199-1996) and EDIC 'Year 6' (1998-2000). This article contains data on the associations of DCCT baseline lipoprotein profiles (NMR-based VLDL & chylomicrons, IDL/LDL and HDL subclasses and 'conventional' total, LDL-, HDL-, non-HDL-cholesterol and triglycerides) with carotid IMT at EDIC Years 1 and 6, stratified by gender. The data are supplemental to our original research article describing detailed associations of DCCT baseline lipids and lipoprotein profiles with EDIC Year 12 carotid IMT (Basu et al. in press) [1].

  20. Distribution Characteristics and Related Factors of Carotid Intima-Media Thickness in Middle and Elder Aged Population%中老年人群颈动脉内中膜厚度分布特征及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    罗杰斯; 谢高强; 于洋; 王梦; 史平; 任福秀; 高炜; 武阳丰

    2013-01-01

    Objective:To explore the current distribution characteristics and related factors of carotid intima-media thickness in middle and elder aged population.Methods:From October to November 2012,the cross-sectional examination for cardiovascular risk factors and B-mode ultrasound imaging on carotid arteries were performed in participants at Shijingshan area in Beijing by China-US (PRC-USA) collaborative study.Results:The study investigated a total of 1345 people.There 1277 subjects at the age of (52~88) years with complete information were analyzed.The mean intima-media thickness (IMT) of carotid arteries was (0.68 ± 0.10) mm.The carotid IMT increased accordingly with the elevated age in both male and female genders and the trend analysis had the statistic meaning,P<0.001.The mean IMT in male was thicker than female at all age stages,P<0.01.Multivariate analysis presented that the mean IMT increased with the elevated age,systolic blood pressure,triglyceride and body mass index,P<0.05.Conclusion:In addition to age and gender,the blood pressure,glucose,lipids and obesity were related to carotid intima-media thickness,and those factors should be focused for cardiovascular disease prevention and treatment.%目的:探讨中老年人群颈动脉内中膜厚度分布特征的现状及其相关因素.方法:于2012-10至2012-11,对中美心血管病和心肺疾病流行病学合作研究中的石景山人群复查心血管病危险因素并进行颈动脉超声检查,以此横断面数据进行分析.结果:共计调查1345人.其中1 277人数据完整者纳入分析,年龄52~88岁.颈动脉内中膜厚度平均值为(0.68±0.10)mm,两性均随年龄而增加,趋势分析具有统计学意义(P<0.001).各年龄阶段颈动脉内中膜平均厚度男性均大于女性(P<0.01).多因素分析结果显示:男女两性颈动脉内中膜厚度随着年龄、收缩压、血糖、甘油三酯和体质指数的增加而增加(P<0.05).结论:除年龄和性别外,血

  1. Dynamic programming in parallel boundary detection with application to ultrasound intima-media segmentation.

    Science.gov (United States)

    Zhou, Yuan; Cheng, Xinyao; Xu, Xiangyang; Song, Enmin

    2013-12-01

    Segmentation of carotid artery intima-media in longitudinal ultrasound images for measuring its thickness to predict cardiovascular diseases can be simplified as detecting two nearly parallel boundaries within a certain distance range, when plaque with irregular shapes is not considered. In this paper, we improve the implementation of two dynamic programming (DP) based approaches to parallel boundary detection, dual dynamic programming (DDP) and piecewise linear dual dynamic programming (PL-DDP). Then, a novel DP based approach, dual line detection (DLD), which translates the original 2-D curve position to a 4-D parameter space representing two line segments in a local image segment, is proposed to solve the problem while maintaining efficiency and rotation invariance. To apply the DLD to ultrasound intima-media segmentation, it is imbedded in a framework that employs an edge map obtained from multiplication of the responses of two edge detectors with different scales and a coupled snake model that simultaneously deforms the two contours for maintaining parallelism. The experimental results on synthetic images and carotid arteries of clinical ultrasound images indicate improved performance of the proposed DLD compared to DDP and PL-DDP, with respect to accuracy and efficiency.

  2. Resistência insulínica pode prejudicar a redução da espessura mediointimal em adolescentes obesos Insulin resistance can impair reduction on carotid intima-media thickness in obese adolescents

    Directory of Open Access Journals (Sweden)

    Priscila de Lima Sanches

    2012-10-01

    (IR n=39 and without insulin resistance (NIR n=27, and submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery intima-media thickness (cIMT, visceral and subcutaneous adipose tissue was determined by ultrasound. Body composition, blood pressure, HOMA-IR, lipid profile and adipokines concentrations [leptin, adiponectin, and plasminogen activator inhibitor type (PAI-1] were analyzed before and after the therapy. RESULTS: Both groups presented significant improvements in body composition, inflammatory state (reduction of leptin and PAI-1 concentration; increasing of plasma adiponectin and reduction of cIMT. Only NIR group showed positive correlation between changes in visceral fat (∆Visceral and changes in cIMT (∆ cIMT (r = 0.42; p < 0.05. Simple linear regression analyze revealed ∆Visceral to be an independent predictor to reduction of cIMT in this group (R2 adjusted = 0.14, p = 0.04. The final values of cIMT remained significantly higher in IR group when compared to NIR group. CONCLUSION: The presence of insulin resistance can impair changes in cIMT leading to early development of atherosclerosis in obese adolescents submitted to an interdisciplinary intervention..

  3. 2型糖尿病患者尿微量白蛋白与颈动脉内中膜相关性研究%Research on the relationship between microalbuminuria and carotid intima media thickness in type 2 diabetic patient

    Institute of Scientific and Technical Information of China (English)

    穆雅慧; 骆丽娅; 董科娜; 耿河川; 田云龙; 刘静

    2015-01-01

    目的探讨2型糖尿病患者尿微量白蛋白( UMA)与颈动脉内中膜厚度( IMT)的关系,研究微量白蛋白尿在2型糖尿病患者中预测大血管病变的价值。方法选取尿微量白蛋白异常的2型糖尿病患者111例,根据尿微量蛋白水平分为尿蛋白正常组64例(尿微量白蛋白30mg/L)。微量尿蛋白组又分为3个亚组,即A组19例(尿微量白蛋白30~50mg/L),B组14例(尿微量白蛋白50~100mg/L),C组14例(尿微量白蛋白100~300mg/L)。比较各组及各亚组微量尿蛋白水平及颈动脉内中膜厚度,探讨其相关关系。结果UMA与IMT呈正相关性,尿微量白蛋白高即颈动脉内中膜厚度高。结论尿微量白蛋白与颈动脉硬化相关,尿微量白蛋白越高,与颈动脉硬化相关性越密切。尿微量白蛋白可能为2型糖尿病大血管及微血管病变的标志物。%Objective Research on the relationship between microalbuminuria and carotid intima-media thickness in type 2 diabetic patient,Prediction of major vascular lesions of urinary albumin in type 2 diabetes mellituspatients value. Method Based on patients with type 2 diabetes in 111 cases. According to the microalbuminuria levels were divided into normal group 64 cases(microalbuminuria30mg/L). Mi-croalbuminuria group was divided into 3 sub groups,namely group A 19 cases(microalbuminuria 30-50mg/L),14 cases in B group(microalbuminuria 50-100mg/L),group C 14 cases with microalbuminuria 100-300mg/L). Comparison of groups and subgroups of microalbuminuria and carotid artery intima-media thickness, and explore its correlation. Result Mi-croalbuminuria and carotid artery intima-media thickness process positive correlation. Conclusion Microalbuminuria may be the marker of macrovascular and microvessels disease in type2 diabetes mellitus.

  4. Obesity and carotid artery remodeling

    DEFF Research Database (Denmark)

    Kozakova, M; Palombo, C; Morizzo, C

    2015-01-01

    BACKGROUND/OBJECTIVE: The present study tested the hypothesis that obesity-related changes in carotid intima-media thickness (IMT) might represent not only preclinical atherosclerosis but an adaptive remodeling meant to preserve circumferential wall stress (CWS) in altered hemodynamic conditions...... and CCA LD (266 healthy subjects with wide range of body weight (24-159 kg)); (B) longitudinal associations between CCA LD and 3-year IMT progression rate (ΔIMT; 571 healthy non-obese subjects without increased cardiovascular (CV) risk); (C) the impact of obesity on CCA geometry and CWS (88 obese subjects...... without CV complications and 88 non-obese subjects matched for gender and age). RESULTS: CCA LD was independently associated with SV that was determined by body size. In the longitudinal study, baseline LD was an independent determinant of ΔIMT, and ΔIMT of subjects in the highest LD quartile...

  5. Determination of bilateral symmetry of carotid artery structure and function in children and adolescents

    Directory of Open Access Journals (Sweden)

    Uithoven KE

    2017-01-01

    Full Text Available Katelyn E Uithoven,1 Justin R Ryder,2 Roland Z Brown,3 Kyle D Rudser,3 Nicholas G Evanoff,1 Donald R Dengel,1,2 Aaron S Kelly2,4 1School of Kinesiology, University of Minnesota, 2Department of Pediatrics, University of Minnesota Medical School, 3Division of Biostatistics, School of Public Health, University of Minnesota, 4Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA Abstract: The carotid artery represents an ideal location for noninvasive assessment of subclinical atherosclerosis in youth. Examination of arterial structure and function is generally conducted in the left common carotid. However, if the left common carotid is inaccessible or provides a poor acoustic window, it is unknown if the right common carotid can provide comparable values. The symmetry of carotid arteries in youth with high-resolution ultrasound was compared. Participants (N=230 [121 females], 13.8±2.9 years old were assessed for carotid intima media thickness (cIMT, carotid lumen diameter (cLD, carotid incremental elastic modulus (cIEM, carotid diameter compliance (cDC, carotid cross-sectional compliance (cCSC, carotid diameter distensibility (cDD, and carotid cross-sectional distensibility (cCSD. No significant differences (P>0.05 all were found for cIMT (0.49±0.09 vs 0.49±0.08 mm, cIEM (1095±382 vs 1116±346 mmHg, cDC (0.01±0.0 vs 0.01±0.0 mm/mmHg, cCSC (0.01±0.001/mmHg vs 0.01±0.001/mmHg, cDD (14.0%±3.16% vs 13.7%±3.18%, and cCSD (30.1%±7.37% vs 29.4%±7.36%. Significant differences were found for cLD (6.06±0.62 mm vs 6.33±0.64 mm, P<0.001. The majority of measures for arterial structure and function are comparable between the left and right common carotid arteries. There were differences present for cLD; however, these discrepancies are likely due to anatomical differences between the left and right common carotid arteries. Therefore, if the left common carotid is unable to be assessed properly, the right common

  6. Update of the effect estimates for common variants associated with carotid intima media thickness within four independent samples: The Bonn IMT Family Study, the Heinz Nixdorf Recall Study, the SAPHIR Study and the Bruneck Study.

    Science.gov (United States)

    Geisel, Marie H; Coassin, Stefan; Heßler, Nicole; Bauer, Marcus; Eisele, Lewin; Erbel, Raimund; Haun, Margot; Hennig, Frauke; Moskau-Hartmann, Susanna; Hoffmann, Barbara; Jöckel, Karl-Heinz; Kedenko, Lyudmyla; Kiechl, Stefan; Kollerits, Barbara; Mahabadi, Amir-Abbas; Moebus, Susanne; Nürnberg, Gudrun; Nürnberg, Peter; Paulweber, Bernhard; Vens, Maren; Willeit, Johann; Willeit, Karin; Klockgether, Thomas; Ziegler, Andreas; Scherag, André; Kronenberg, Florian

    2016-06-01

    Carotid intima media thickness (cIMT) is a marker for subclinical atherosclerosis. The most recent genome-wide association meta-analysis (GWAMA) from the CHARGE consortium identified four genomic regions showing either significant (ZHX2, APOC1, PINX1) or suggestive evidence (SLC17A4) for an association. Here we assess these four cIMT loci in a pooled analysis of four independent studies including 5446 individuals by providing updated unbiased effect estimates of the cIMT association signals. The pooled estimates of our four independent samples pointed in the same direction and were similar to those of the GWAMA. When updating the independent second stage replication results from the earlier CHARGE GWAMA by our estimates, effect size estimates were closer to those of the original CHARGE discovery. A fine-mapping approach within a ±50 kb region around each lead SNP from CHARGE revealed 27 variants with larger estimated effect sizes than the lead SNPs but only three of them showed a r(2) > 0.40 with these respective lead SNPs from CHARGE. Some variants are located within potential functional loci.

  7. Hyperuricemia and carotid artery dilatation among young adults without metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Eswar Krishnan

    2012-10-01

    Full Text Available It is not known if hyperuricemia is associated with early vascular changes signifying arteriosclerosis. We performed a cross sectional study of 163 young adults without metabolic syndrome in Allegheny County, PA, USA. Doppler ultrasound was used to measure two metrics of early arteriosclerosis: carotid artery dimensions and aortic pulse wave velocity. Individuals in the highest quartiles of serum uric acid (>6.2 mg/dL for men and >4.6 for women were more likely to be of younger age, and to possess greater measures of adiposity and an adverse cardiovascular risk profile. Higher serum uric acid concentration was associated with larger luminal and adventitial diameters as well as changes in diameters between the phases of the cardiac cycle (P<0.001 but not with carotid intima media thickness, pulse wave velocity, or pressure strain modulus. In multivariable linear regression models where the effects of age, ethnicity, serum creatinine, systolic blood pressure, current alcohol use, body mass index and smoking status were accounted for, the highest quartile of serum uric acid was associated with greater luminal and adventitial diameters and change in luminal diameter between the phases of cardiac cycle (P<0.05, but not with pulse wave velocity, pressure strain modulus or carotid intima media thickness. We can conclude that hyperuricemia is associated with larger carotid artery diameters signifying an early adaptive response to vascular stress. This has implications on the observed link between hyperuricemia and hypertension.

  8. Effects of biphasic, basal-bolus or basal insulin analogue treatments on carotid intima-media thickness in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Lundby-Christensen, Louise; Vaag, Allan; Tarnow, Lise;

    2016-01-01

    in combination with insulin detemir once daily (n=138) versus insulin detemir alone once daily (n=137), aiming at HbA1c≤7.0% (≤53 mmol/mol). OUTCOMES: Primary outcome was change in mean carotid IMT (a marker of subclinical cardiovascular disease). HbA1c, insulin dose, weight, and hypoglycaemic and serious...

  9. Effect of rimonabant on carotid intima-media thickness (CIMT) progression in patients with abdominal obesity and metabolic syndrome: the AUDITOR Trial

    NARCIS (Netherlands)

    O'Leary, D.H.; Reuwer, A.Q.; Nissen, S.E.; Després, J.P.; Deanfield, J.E.; Brown, M.W.; Zhou, R.; Zabbatino, S.M.; Job, B.; Kastelein, J.J.P.; Visseren, F.L.J.

    2011-01-01

    OBJECTIVE: The aim of this trial was to determine whether obese patients benefit from treatment with rimonabant in terms of progression of carotid atherosclerosis. Rimonabant, a selective cannabinoid-1 receptor blocker, reduces body weight and improves cardiometabolic risk factors in patients who ar

  10. Carotid artery stenting will replace carotid endarterectomy.

    Science.gov (United States)

    McCormick, Daniel J; Vlad, Tudor; Fasseas, Panayotis

    2007-09-01

    Stroke is the third leading cause of death in the United States. Carotid artery stenosis represents one of the most common etiologies of stroke. The current treatment modalities available for the treatment of carotid artery stenosis are carotid endarterectomy (CEA) and carotid artery stenting (CAS). Several clinical trials comparing CEA with medical management showed superiority of the surgical arm; however, the applicability of these results to the general population is limited by the fact that the patients and surgeons enrolled in these trials were carefully selected, and the optimal medical therapy used does not meet the current treatment standards. Carotid artery stenting has emerged as a treatment alternative to CEA, as shown in randomized trials comparing the 2 treatment modalities. Recent data from large-volume CAS registries indicate that percutaneous treatment of carotid artery stenosis compares favorably to CEA. Furthermore, the CAS trial designs make these results more applicable to the community standards. These data suggest that CAS will become the treatment of choice in patients with carotid artery stenosis.

  11. [Grafting of carotid arteries].

    Science.gov (United States)

    Belov, Iu V; Stepanenko, A B; Gens, A P; Bazylev, V V; Seleznev, M N; Savichev, D D

    2005-01-01

    Over 5-years, 167 reconstructive surgeries for stenosis of internal carotid arteries (ICA) were performed in 124 patients. Mean age of the patients was 63.5 years. One hundred and twenty-nine carotid endarterectomies (CEAE) in 86 patients and 38 reconstructive operations of ICA in 38 patients were performed. There were no lethal outcomes in short- and long-term postoperative period. In short-term period after prosthesis of ICA restenosis was revealed in 3% patients, after eversion CEAE in 3% patients the embolism was seen, after standard CEAE restenosis were diagnosed in 8% patients and thrombosis -- in 3%. In long-term period after grafting of ICA the strokes were seen in 3%, stenosis -- in 6% patients, after eversion endarterectomy -- in 0 and 3% patients, and after standard CEAE -- in 3 and 24% patients, respectively. It is concluded that grafting of ICA is adequate surgical method of reconstruction and stroke prevention in specific variants of carotid atherosclerosis.

  12. Social mobility and subclinical atherosclerosis in a middle-income country: Association of intra- and inter-generational social mobility with carotid intima-media thickness in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Guimarães, Joanna M N; Clarke, Philippa; Tate, Denise; Coeli, Claudia Medina; Griep, Rosane Harter; Fonseca, Maria de Jesus Mendes da; Santos, Itamar S; Melo, Enirtes Caetano Prates; Chor, Dora

    2016-11-01

    Over the past half century Brazil has undergone a process of dramatic industrialization and urbanization. Cardiovascular diseases (CVD) have become common due to rapid demographic, epidemiologic, and nutritional transitions. The association of social mobility with subclinical CVD has been rarely explored, particularly in developing societies. We investigated the association of intra- and inter-generational social mobility with carotid intima-media thickness (IMT), a marker of subclinical or asymptomatic atherosclerosis, in a large Brazilian sample (ELSA-Brasil). We used baseline data (2008-2010) for 7343 participants from ELSA-Brasil. Intra-generational social mobility was defined as the change in occupational social class between participants' first occupation and current occupation. Inter-generational social mobility was defined as the change in occupational social class of the head of the household when the participant started working and participants' current occupation. Social mobility groups were classified as: stable high (reference), upward, downward and stable low. Linear regression models were used to examine the associations between type of social mobility and IMT. Compared to those who experienced stable high occupational status across generations, downward inter-generational mobility was associated with greater IMT. Additionally, those who declined the most in occupational status had the highest values of IMT, even after adjustments for lifestyle and cardiovascular factors. For intra-generational mobility, stable low versus stable high social mobility was independently associated with higher IMT. Subclinical atherosclerosis is patterned by socioeconomic status both within and across generations, demonstrating an association even before symptoms of CVD appear. The health consequences of downward inter-generational social mobility were not fully explained by lifestyle and cardiovascular factors, whereas being consistently exposed to low occupational

  13. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

  14. Correlation Study of Carotid Intima_media Thickness,Carotid Plaques and SYNTAX Score in Patients with Coronary Heart Disease%冠心病患者颈动脉内膜中层厚度及颈动脉斑块与 SYNTAX 评分的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王林; 袁国裕; 陈国雄; 陈士良

    2016-01-01

    Objective To explore the association of carotid intima_media thickness (CIMT ) ,carotid plaques with SYNTAX score of coronary artery in patients with coronary heart disease(CHD). Methods 256 patients who underwent coronary arteriography (CAG) were divided into control group with their coronary stenosis 32scores).CIMT and catotid plaques were evaluated with ultrasonic inspection and measurement in all patients. Results Incidence rates of elevated CIMT and carotid plaques were significantly higher in CHD group than in the control group ( P32scores) than in the low risk group (1~22scores). The Spearman linear_regression analysis showed that SYNTAX scores had a positive correlation with CIMT ( r=0.64 ,P32 ( P<0.05).Conclusions CIMT and carotid plaques were closely associated with SYNTAX scores in patients with CHD ,which could be used to indirectly predict the severity of coronary artery lesion.%目的:探讨冠心病患者颈动脉内膜中层厚度(CIMT )及颈动脉斑块与冠状动脉SYNTAX评分的关系。方法选择行冠状动脉造影的患者256例,根据冠状动脉造影结果分组:51例冠状动脉狭窄<50%为对照组,余205例为冠心病组。冠心病组又根据SYNTAX评分结果分为低分组(1~22分)70例、中分组(23~32)94例、高分组(>32分)41例。所有患者均采用超声检测双侧CIMT及颈动脉斑块情况。结果与对照组比较,冠心病组患者CIMT及斑块发生率明显高于对照组( P<0.05)。与低分组比较,中分组和高分组CIMT及斑块发生率明显升高( P<0.05)。Spearman线性回归分析结果显示冠心病患者CIMT与SYNTAX评分呈直线正相关( r=0.64,P<0.01)。多因素Logistic回归分析结果显示,CIMT及颈动脉斑块是SYNTAX积分>32分的独立预测因素( P<0.05)。结论 CIMT及颈动脉斑块与冠心病患者SYNTAX评分密切相关,可间接预测冠状动脉病变严重程度。

  15. Intima-media thickness evaluation by B-mode ultrasound: Correlation with blood pressure levels and cardiac structures

    Directory of Open Access Journals (Sweden)

    F.L. Plavnik

    2000-01-01

    Full Text Available The aim of this study was to analyze the thickness of the intima-media complex (IMC using a noninvasive method. The carotid and femoral common arteries were evaluated by noninvasive B-mode ultrasound in 63 normotensive and in 52 hypertensive subjects and the thickness of the IMC was tested for correlation with blood pressure, cardiac structures and several clinical and biological parameters. The IMC was thicker in hypertensive than in normotensive subjects (0.67 ± 0.13 and 0.62 ± 0.16 vs 0.54 ± 0.09 and 0.52 ± 0.11 mm, respectively, P<0.0001. In normotensive patients, the simple linear regression showed significant correlations between IMC and age, body mass index and 24-h systolic blood pressure for both the carotid and femoral arteries. In hypertensives the carotid IMC was correlated with age and 24-h systolic blood pressure while femoral IMC was correlated only with 24-h diastolic blood pressure. Forward stepwise regression showed that age, body mass index and 24-h systolic blood pressure influenced the carotid IMC relationship (r2 = 0.39 in normotensives. On the other hand, the femoral IMC relationship was influenced by 24-h systolic blood pressure and age (r2 = 0.40. In hypertensives, age and 24-h systolic blood pressure were the most important determinants of carotid IMC (r2 = 0.37, while femoral IMC was influenced only by 24-h diastolic blood pressure (r2 = 0.10. There was an association between carotid IMC and echocardiographic findings in normotensives, while in hypertensives only the left posterior wall and interventricular septum were associated with femoral IMC. We conclude that age and blood pressure influence the intima-media thickness, while echocardiographic changes are associated with the IMC.

  16. Initial exploration of early carotid artery endothelial dysfunction in type 2 diabetes mellitus patients evaluated by ultrasound radio-frequency technique

    Institute of Scientific and Technical Information of China (English)

    LI Miao-shan; WANG Man-li; WU Li-sang; ZHU Wu; WU Yan-ping

    2016-01-01

    Background The early endothelial dysfunction of carotid artery in patients with type 2 diabetes mellitus (T2DM) has been recognized.However,the feasibility and significance of carotid artery endothelial dysfunction detected by ultrasound radio-frequency technology has been seldom studied.Methods The 2D ultrasound images of the bilateral common carotid arteries from 112 cases of T2DM patients and 50 cases of normal subjects in our hospital were collected to measure intima-media thickness means (IMTm),end-systolic inner diameter (Ds),end-diastolic inner diameter (Dd),resistance index (RI),pulse index (PI),and the systole/diastole ratio (S/D).We also observed the variation of the intima-media thickness (IMT) as well as the elasticity indexes of the common carotid artery,such as the compliance coefficient (CC),elasticity coefficient (β),pulse wave velocity (PWV) and augmentation index (AIx) through instruments with built-in ultrasound radio-frequency techniques,including quantitative intima-media thickness (QIMT) and quantitative analysis of arterial stiffness (QAS).The differences of the above-mentioned parameters between the two groups were analyzed.Results There were no statistically significant differences in IMTm,Ds,Dd,RI,PI and S/D raito of the common carotid arteries between group T2DM and the normal group (P > 0.01).The β,PWV and AIx in group T2DM were remarkably higher than those in the control group,with CC value being significantly lower than the later (P < 0.01 or 0.05).Conclusion Ultrasound radio-frequency technique offers earlier and more effective evaluation of carotid artery endothelial dysfunction in T2DM patients when compared with conventional 2D ultrasound,establishing imaging foundation for the early prevention and treatment of cardio-cerebrovascular complications in T2DM patients.

  17. A study on the carotid artery ultrasonography for the metabolic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Hye Jung; Cho, Pyong Kon [Dept. of Radiological Science, Catholic University of Daegu, Daegu (Korea, Republic of); Kang, Young Han [Dept. of Radiology, Catholic University Hospital of Daegu, Daegu (Korea, Republic of)

    2013-09-15

    The primary goal of this study was to ascertain the primary factors to the affect for the carotid artery intima-media thickness (IMT), the prevalence of metabolic syndrome and other risks can possibly influence the carotid artery IMT. All patients data (total specimens: 289, male: 197, female: 92) including the carotid artery ultrasonography examination. The all data were analyzed by the use of SPSS software, version 21.0 (SPSS, Chicago, IL USA), with the descriptive statistics method. The Results of this study was found to be highly increased in the males than the females. The prevalence of metabolic syndrome in all of the participants was 30.5 percentages. The carotid artery IMT in the subjects with metabolic syndrome was significantly high in both genders, compared to the rest, who were without metabolic syndrome. The Pearsons correlation coefficient of metabolic syndrome and CIMT was 0.378(p<0.01). In conclusions, the present study also supports the association between the carotid artery IMT and the metabolic syndromes with cardiovascular risk factors. Usage of B-mode ultrasonography to measure the carotid artery IMT was found to be highly effective in the current analysis.

  18. 川崎病恢复期颈动脉内膜-中膜厚度变化及相关因素分析%Study of carotid intima media thickness and its correlated factors in children at the convalescent phase of Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    牛峰海; 王瑜; 蔡文仙; 范国贞; 任雪云

    2012-01-01

    Objective To observe the change of carotid intima-media thickness and analysis of its correlated factors at the convalescent phase in children with Kawasaki disease, and to provide a scientific basis for prevention and treatment of vascular lesions. Methods A cohort of 60 children during the age of 2 to 4 years old was studied, which comprised 30 children at the convalescence phase of Kawasaki disease (KD group) and 30 healthy age-matched children (control group). Carotid arterial intima-media thickness (IMT) , malondialdehyde ( MDA) , interleukin-1 beta (IL-1|3) , interferon-gamma (IFN-7) and body mass index (BMI) were evaluated. Results IMT in KD group and control group was (0.40 ± 0.03) mm and (0.37 ± 0.04) mm respectively. IMT in KD group was higher than that in control group (P 0.05). IMT was positively correlated with the plasma level of MDA (r = 0.463, P < 0.05), but not significantly correlated with the levels of IL-iβ, IFN-7 and BMI. Conclusions The increased carotid IMT in children at the convalescent phase of Kawasaki disease is associated with oxidative stress.%目的 观察川崎病(KD)患儿恢复期颈动脉内膜-中膜厚度变化及相关因素,为防治KD血管病变提供科学依据.方法 收集30例2 ~ 4岁KD恢复期患儿及30例同年龄健康儿童,测定其颈动脉内膜-中膜厚度(IMT)、丙二醛(MDA)、白介素-1β(IL-1β)、γ-干扰素(IFN-γ)和体质指数(BMI).结果 KD患儿颈动脉IMT为(0.40 ± 0.03)mm,对照组为(0.37 ± 0.04)mm,两者比较差异有统计学意义.KD患儿MDA 为(2.56±0.18)nmol/ml,对照组为(2.09±0.24)nmol/ml,两者比较差异有统计学意义.两组间IL-1β、IFN-γ、BMI比较,差异均无统计学意义.直线相关分析显示,颈动脉IMT与MDA呈正相关(r = 0.463,P < 0.05),而与IL-1β、IFN-γ和 BMI水平均无相关性(P均> 0.05).结论 KD恢复期患儿颈动脉内膜-中膜增厚,与氧化应激有关.

  19. Early and current physical activity: relationship with intima-media thickness and metabolic variables in adulthood

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    Manoel C. S. Lima

    2014-10-01

    Full Text Available Background: It is unclear whether early physical activity has a greater influence on intima-media thickness and metabolic variables than current physical activity. Objective: To analyze the relationship between current and early physical activity, metabolic variables, and intima-media thickness measures in adults. Method: The sample was composed of 55 healthy subjects of both sexes (33 men and 22 women. Total body fat and trunk fat were estimated by dual-energy X-ray absorptiometry. Carotid and femoral intima-media thickness were measured using a Doppler ultrasound device. A 12-hour fasting blood sample collection was taken (fasting glucose and lipid profile. Early physical activity was assessed through face-to-face interview, and the current physical activity was assessed by pedometer (Digi-Walker Yamax, SW200, which was used for a period of seven days. Results: Current physical activity was negatively related to total cholesterol (rho=-0.31, while early physical activity was negatively related to triglycerides (rho=-0.42, total cholesterol (rho=-0.28, very low density lipoprotein (rho=-0.44, and carotid intima-media thickness (rho=-0.50. In the multivariate model, subjects engaged in sports activities during early life had lower values of very low density lipoprotein (b=-8.74 [b=-16.1; -1.47] and carotid intima-media thickness (b=-0.17 [95%CI: -0.28; -0.05]. Conclusion: Early 95%CI physical activity has a significant influence on carotid intima-media thickness, regardless of the current physical activity.

  20. A discussion of the value of testing carotid intima-media thickness by ultrasound to cardio-cerebro-vascular disease%超声检测颈动脉内中膜厚度在心脑血管疾病中的价值探讨

    Institute of Scientific and Technical Information of China (English)

    杨丽丽; 余凤

    2015-01-01

    目的:探讨超声检测颈动脉内中膜厚度在心脑血管疾病中的应用价值。方法2012年1月~2014年6月我院超声检测颈动脉内中膜厚度共2167例,根据超声检测结果,分为正常组和异常组,统计两组患者心脑血管疾病患病情况。结果2167例受检者经超声检测,IMT异常893例(41.21%),其中,内中膜增厚112例(5.17%),粥样硬化斑块674例(31.10%),颈动脉狭窄107例(4.94%),以轻中度狭窄最为常见, IMT正常组中心血管病发病率为4.95%,异常组为35.95%,两组差异具有统计学意义(P<0.05);正常组中脑血管病发病率为3.53%,异常组为26.88%,两组差异具有统计学意义(P<0.05);IMT异常组中高血压和短暂性脑缺血发作(TIA)的发病率分别明显高于其他心脑血管疾病,差异具有统计学意义(x2a=6.569, P<0.05;x2b=7.247,P<0.05)。结论超声检测颈动脉内中膜厚度对心脑血管疾病早期预防、早期诊断、早期干预具有重要意义。%Objective To discuss the application value of testing carotid intima-media thickness by ultrasound to cardio-cerebro-vascular disease (CCVD).Methods 2167 cases tested carotid intima-media thickness by ultrasound in our hospital during January 2012 to June 2013 were divided into normal group and abnormal group according to the ultrasound attenuation detecting results. And the prevalence situation of CCVD of patients in the two groups was counted.Results2167 cases were examined by ultrasound in which 893 (41.21%)people's IMT were abnormal. Among them, 112 cases (5.17%)had thickening of their internal medial, 674 cases(31.10%) had atherosclerotic plaque, 107 cases(4.94%) were of carotid artery stenosis in which Mild-to-moderate carotid stenosis was the most common. The morbidity of cardiovascular disease was 4.95% in IMT normal group and 35.95% in abnormal group, it showed a significant difference between

  1. [Carotid and brachial intima-media thickness of the allelic variants G894T and T-789C of eNOS in systemic sclerosis patients].

    Science.gov (United States)

    Martínez-Godínez, Ángeles; Miliar-García, Ángel; Bautista-Jiménez, María Itandehui; Jandete-Rivera, Fernando; Vera-Lastra, Olga Lidia; Jara, Luis J; Bizueto-Rosas, Héctor; del Pilar Cruz-Domínguez, María

    2015-01-01

    Introducción: el objetivo de este estudio es evaluar comparativamente el grosor íntima-media (IMT) carotídeo y braquial con ultrasonido Doppler, la presión arterial pulmonar ecocardiográfica y la variación alélica de los genes G894T y T-789C de la eNOS en pacientes con esclerodermia. Métodos: estudio transversal en pacientes con esclerodermia. Criterios de inclusión: edad 18-70 años, diagnosticado con esclerodermia, previo consentimiento informado. Se evaluó IMT, índice de resistencia (IR) e índice de pulsatilidad (IP) mediante Doppler carotídeo y braquial, perfil de lípidos, proteína C reactiva, polimorfismo G894T y T-789C de óxido nítrico sin tasa endotelial (eNOS). Analizamos con estadística descriptiva, prueba t de Student o chi cuadrada para asociación de variables y Spearman para correlacionar las variables cuantitativas. Resultados: encontramos IMT anormalmente alto en arterias carotídeas y braquiales. Observamos baja correlación entre ambas braquiales, buena correlación entre carótidas y ninguna correlación entre carótidas y braquiales. El IMT braquial izquierdo > 0.65 corresponde con presión arteria pulmonar > 30 mmHg ecocardiográfica. El polimorfismo del gen G894T se asoció con mayor IMT en carótida derecha.Conclusión: El polimorfismo G894T de eNOS se asocia a mayor IMT en carótida derecha. El IMT carotídeo concuerda con su IMT contralateral. El IMT braquial izquierdo mayor a 0.65 sugiere la posibilidad de hipertensión arterial pulmonar.

  2. Traditional risk factors are more relevant than HIV-specific ones for carotid intima-media thickness (cIMT in a Brazilian cohort of HIV-infected patients.

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    Antonio G Pacheco

    Full Text Available Combination antiretroviral therapy (cART had a dramatic impact on the mortality profile in human immunodeficiency virus (HIV infected individuals and increased their life-expectancy. Conditions associated with the aging process have been diagnosed more frequently among HIV-infected patients, particularly, cardiovascular diseases.Patients followed in the Instituto de Pesquisa Clínica Evandro Chagas (IPEC prospective cohort in Rio de Janeiro were submitted to the general procedures from the Brazilian Longitudinal Study of Adult Health, comprising several anthropometric, laboratory and imaging data. Carotid intima-media thickness (cIMT was measured by ultrasonography, following the Mannheim protocol. Linear regression and proportional odds models were used to compare groups and covariables in respect to cIMT. The best model was chosen with the adaptive lasso procedure.A valid cIMT exam was available for 591 patients. Median cIMT was significantly larger for men than women (0.56mm vs. 0.53mm; p = 0.002; overall = 0.54mm. In univariable linear regression analysis, both traditional risk factors for cardiovascular diseases (CVD and HIV-specific characteristics were significantly associated with cIMT values, but the best multivariable model chosen included only traditional characteristics. Hypertension presented the strongest association with higher cIMT terciles (OR = 2.51; 95%CI = 1.69-3.73, followed by current smoking (OR = 1,82; 95%CI = 1.19-2.79, family history of acute myocardial infarction or stroke (OR = 1.60; 95%CI = 1.10-2.32 and age (OR per year = 1.12; 95%CI = 1.10-1.14.Our results show that traditional cardiovascular disease (CVD risk factors are the major players in determining increased cIMT among HIV infected patients in Brazil. This finding reinforces the need for thorough assessment of those risk factors in these patients to guarantee the incidence of CVD events remain under control.

  3. Border detection on Common Carotid Artery using Gauss-Markov Estimation

    Science.gov (United States)

    Koya, Yoshiharu; Mizoshiri, Isao

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. The arteriosclerosis of the common carotid artery is diagnosed using Intima-Media Thickness (IMT) which is obtained from echocardiogram. In order to measure IMT from echocardiogram, it is required to detect a border which is a boundary between vessel tissue layers. The method of border detection requires reproducibility, high accuracy and high-speed. In this paper, we propose the high-accuracy and high-speed detection method by Gauss-Markov estimation. About high-accuracy, it realized by attaching importance to high reliable candidate point of border. And, about high-speed, it realized by calculating matrix only one time.

  4. Analysis of the population at high risk of stroke detected with carotid artery ultrasonography in Tianjin urban communities

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    Wei YUE

    2015-04-01

    Full Text Available Objective To investigate the features of carotid atherosclerosis in a population at high risk of stroke in urban communities of Tianjin, so as to provide inspiration for carotid ultrasonography to play a greater role in the prevention and control of stroke.  Methods A total of 956 residents at high risk of stroke were selected from 4 urban communities in Tianjin using cluster random sampling method. Doppler ultrasound screening was performed in bilateral common carotid artery (CCA, internal carotid artery (ICA, external carotid artery (ECA, vertebral artery (VA, subclavian artery (SCA and innominate artery of the population. The intima-media thickness (IMT, atherosclerotic plaque formation and its location and size, vascular stenosis or occlusion, and flow spectrum were detected. The results and features of carotid ultrasound screening were analyzed and compared among different gender and age groups.  Results 1 The detection rate of carotid atherosclerosis was 71.55% (684/956, and the detection rate in males was significantly higher than that in females (79.08% vs 65.87%; χ2 = 20.067, P = 0.000. 2 Among the population with carotid atherosclerosis, the most common manifestation was the formation of atherosclerotic plaques (81.58%, 558/684, secondly intima-media thickening (13.01%, 89/684, followed by moderate to severe stenosis or occlusion (5.41%, 37/684. The proportion of intima-media thickening in males was lower than that in females (7.08% vs 18.38%; χ2 = 19.269, P = 0.000. The proportion of carotid atherosclerotic plaque formation in males was higher than that in females (86.46% vs 77.16%; χ2 = 9.824, P = 0.002. The median rating of carotid atherosclerosis was 1.79, with males higher than females [1.98 (0.70, 3.26 vs 1.52 (0.20, 2.84; Z = 2.304, P = 0.042]. The site of plaque formation was most commonly located in carotid bulb (36.61%, secondly SCA (22.18%. Of the type of carotid stenosis, ICA stenosis was detected in 30 cases, VA

  5. 红细胞分布宽度与阻塞性睡眠呼吸暂停低通气综合征病情和颈动脉内膜中层厚度的相关性%Relation of red blood cell distribution width with the severity and carotid intima media thickness of obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    陈碧; 陈昊; 张淼; 刘文静; 赵力; 朱述阳; 张文辉

    2015-01-01

    Objective To explore the relationship between red cell distribution (RDW) level with the severity and carotid intima media thickness of obstructive sleep apnea hypopnea syndrome (OSAHS).Methods A total of 103 patients with OSAHS diagnosed by polysomnography were selected from sleep Disorders Center at Affiliated Hospital of Xuzhou Medical College between January 2013 and August 2014.Twenty-eight healthy adult individuals matched for age and body mass index (BMI) were enrolled as the control group in this study.The blood routine parameters including RDW,hemoglobin level,and mean corpuscular volume (MCV) were determined.The carotid intima-mesa thickness (IMT) was measured by color Doppler uhrasonography.In addition,the correlations were analyzed between RDW with the severity and carotid IMT of OSAHS.Results The RDW values were significantly increased in moderate to severe OSAHS patients compared to the controls (all P <0.05).The RDW was positively correlated with AHI and negatively correlated with minimum SaO2.The carotid IMT was higher in milder to severe OSAHS patients than that in controls and there was a significant difference in carotid IMT among three OSAHS groups (all P <0.05).RDW in OSAHS patients was positively correlated with carotid IMT(r =0.52,P < 0.001).Conclusions RDW was significantly increased in OSAHS patients and was positively correlated with the severity and carotid IMT of OSAHS.These findings suggest that RDW may be a predictive marker of OSAHS severity and carotid artery atherosclerosis in OSAHS.%目的 探讨OSAHS患者红细胞分布宽度(RDW)与病情严重程度和颈动脉粥样硬化的相关性.方法 选取2013~2014年间在徐州医学院附属医院经多导睡眠监测(PSG)确诊的OSAHS患者103例,以及年龄、性别、体质量指数相匹配的28名健康对照者为研究对象,测定血RDW、红细胞计数(RBC)、血红蛋白(HB)、平均红细胞体积(MCV)等血常规参数,应用彩色多普勒超声仪检测颈

  6. Race or vitamin D: A determinant of intima media thickness in obese adolescents?

    Science.gov (United States)

    Carotid intima media thickness (IMT), a predictor of cardiovascular events, is reported to be higher in African-American (AA) vs. White (AW) individuals. We investigated whether racial differences in IMT in obese adolescents could be explained by differences in 25 hydroxy-vitamin D [25(OH)D]. A tota...

  7. White Matter Lesions, Carotid and Coronary Atherosclerosis in Late-Onset Depression and Healthy Controls

    DEFF Research Database (Denmark)

    Devantier, Torben Albert; Nørgaard, Bjarne Linde; Poulsen, Mikael Kjær

    2016-01-01

    for the formation of WMLs in depression. METHODS: The case-control study included 29 patients with late-onset major depressive disorder and 27 controls matched for sex, age, and tobacco use. WML volume, carotid intima-media thickness, and coronary plaque volume were assessed using magnetic resonance imaging...... between carotid intima-media thickness and WML volume was, however, similar in patients and controls. CONCLUSIONS: In older persons aged between 50 and 70 years, WMLs do not seem to be a part of generalized atherosclerotic disease, but seem to be dependent on atherosclerosis in the carotid arteries...

  8. Estimation of prenatal aorta intima-media thickness from ultrasound examination

    Science.gov (United States)

    Veronese, E.; Tarroni, G.; Visentin, S.; Cosmi, E.; Linguraru, M. G.; Grisan, E.

    2014-10-01

    Prenatal events such as intrauterine growth restriction and increased cardiovascular risk in later life have been shown to be associated with an increased intima-media thickness (aIMT) of the abdominal aorta in the fetus. In order to assess and manage atherosclerosis and cardiovascular disease risk in adults and children, in recent years the measurement of abdominal and carotid artery thickness has gained a growing appeal. Nevertheless, no computer aided method has been proposed for the analysis of prenatal vessels from ultrasound data, yet. To date, these measurements are being performed manually on ultrasound fetal images by skilled practitioners. The aim of the presented study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from routine third trimester ultrasonographic fetal data. The algorithm locates the aorta, then segments it and, by modeling the arterial wall longitudinal sections by means of a gaussian mixture, derives a set of measures of the aorta diameter (aDiam) and of the intima-media thickness (aIMT). After estimating the cardiac cycle, the mean diameter and the aIMT at the end-diastole phase are computed. Considering the aIMT value for each subject, the correlation between automatic and manual end-diastolic aIMT measurements is 0.91 in a range of values 0.44-1.10 mm, corresponding to both normal and pathological conditions. The automatic system yields a mean relative error of 19%, that is similar to the intra-observer variability (14%) and much lower that the inter-observer variability (42%). The correlation between manual and automatic measurements and the small error confirm the ability of the proposed system to reliably estimate aIMT values in prenatal ultrasound sequences, reducing measurement variability and suggesting that it can be used for an automatic assessment of aIMT. Preliminary results have been presented in E Veronese, E Cosmi, S Visentin, E Grisan: 'Semiautomatic estimation

  9. Medición del espesor miointimal carotídeo como predictor de riesgo de accidente isquémico transitorio Carotid Intima - Media Thickness measurement as a risk predictor of transient ischemic attack Objectives

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    Stella Maris Batallés

    2011-09-01

    Full Text Available Objetivos. Determinar si el riesgo de accidente isquémico transitorio (AIT es mayor en pacientes con valores anormales de espesor miointimal carotídeo (EMIC. Materiales y Métodos. Evaluación de 168 pacientes con y sin AIT estudiados con ecografías de vasos de cuello, midiendo EMIC. Diseño de casos y controles apareados por distintas variables. Análisis estadístico: variables continuas (media ± DS, comparadas mediante prueba "t de Student" para muestras relacionadas. Variables categóricas (porcentajes comparadas mediante pruebas de McNemar. Para evaluar EMIC como predictor de AIT, se ajustaron dos modelos de regresión logística condicional, considerando EMIC como variable continua y como variable binaria EMIC normal (1 mm. Se construyó una curva ROC para evaluar la capacidad discriminativa de EMIC, calculando la sensibilidad y especificidad para diferentes puntos de corte. Resultados. Valor de EMIC: casos 1,03 ± 0,31 mm (IC 95%: 0,97-1,10; controles 0,77 ± 0,27mm (IC 95%: 0,710,83; pTo determine if the risk of transient ischemic attack (TIA is higher in patients with abnormal values of carotid intima-media thickness (CIMT. Materials and Methods. We evaluated 168 patients with and without TIA by ultrasound of the neck vessels, measuring CIMT. Case and controls were matched according to different variables. Statistical analysis: continuous variables (mean ± SD were compared using the Student's t test for related samples. Categorical variables (percentages were compared using the McNemar tests. In order to assess CIMT as a predictor of TIA, two models of conditional logistic regression were adjusted, considering CIMT both as a continuous variable and as a binary variable: normal CIMT (1 mm. A ROC curve was performed to determine the discriminative capacity of CIMT, estimating the sensitivity and specificity for different cutoff values. Results. CIMT value: cases 1.03±0.31 mm (95% CI: 0.971.10; controls 0.77±0.27 mm (95% CI: 0

  10. Research on the relationship between microalbuminuria and carotid intima-media thickness in type 2 diabetic patients%尿微量白蛋白与2型糖尿病患者颈动脉内中膜厚度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    钱红霞; 李新胜; 李佳芮; 赵永才

    2012-01-01

    目的 探讨T2DM患者尿微量白蛋白与颈动脉内膜中层厚度(IMT)的相关性.方法 微量白蛋白尿组(MAU)60例、30名健康者(NC)和30例正常白蛋白尿组(NMAU)作对照,测定血糖、UAER、血压及血肌酐等.采用彩色多普勒超声观察双侧颈动脉内膜中层厚度.结果 NMAU组较NC组FPG、IMT、SBP 明显升高(P<0.05)MAU组较NC组FPG、SBP、UAER、IMT也明显升高(P<0.05);MAU组较NMAU组IMT、UAER显著升高(P<0.01).MAU组患者UAER与IMT呈显著正相关(P<0.05).结论 MAU与颈动脉硬化密切相关,MAU可能为大血管及微血管病变的标志物.%Objective To explore the relationship between microalbuminuria and carotid intima-media thickness in type 2 diabetic patients. Methods Sixty microalbuminuria patients(MAU,UAER20-200 μg/min), 30 nonmicroalbuminuria patients(NMAU, UAER<20 μg/min) and 30 healthy people(NC) were selected in the reserch. The levels of glucose , UAER, blood-pressure and serum creatinine were measured. IMT of carotid arteries were determined with high-sensitive B-mode ultrasound. Results The levels of glucose, IMT,SBP were significantly increased in NMAU versus NC group(all P<0. 05). The levels of glucose, SBP, UAER and IMT were increased significantly in MAU versus NC group (all P< 0. 05). The levels of IMT and UAER were increased in MAU than in NMAU group(P<0. 05). UAER was negatively correlated with IMT. Conclusions Microalbuminuria is negatively correlated with IMT. Microalbuminuria level is likely to be a marker of diabetes' complications.

  11. Relationship between lipidemia and carotid intima-media thickness in patients with cerebral infarction%脑梗死患者血脂水平与颈动脉内中膜厚度的相关性分析

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    肖胜; 陈婧; 汪宏良; 肖劲松

    2012-01-01

    目的 探讨脑梗死(CI)患者血脂水平与颈动脉内中膜厚度(CIMT)的相关性.方法 测定120例CI患者(CI组)和120例神经科非CI患者(对照组)CIMT、血浆氧化低密度脂蛋白(ox-LDL)及血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo-A1)、载脂蛋白B (Apo-B)、脂蛋白(a)[ LP(a)]水平,并进行相关分析.结果 CI组TC、TG、Apo-B、LP(a)和ox-LDL水平高于对照组(P< 0.01);CI组CIMT检测结果 为1.1±0.32 mm,高于对照组的0.8±0.54 mm(P<0.01);CI组TC、TG、LDL-C、Apo-B 、LP(a)、ox-LDL与CIMT呈正相关(P<0.01),HDL-C、Apo-A1与CIMT呈负相关(P<0.01).结论 脂代谢异常与CI患者动脉粥样硬化密切相关;CI患者体内可能存在脂质过氧化反应;抑制脂质过氧化,减少ox-LDL的生成有助于预防和治疗CI.%Objective To investigate the relationship between lipidemia and carotid intima-media thickness (CIMT) in patients with cerebral infarction(CI). Methods CIMT,plasma oxidized low-density lipoprotein(ox-LDL)level and serum level of total cho-lesterol(TC) , triacylglycerol (TG) , low density lipoprotein-cholestero ( LDL-C) , high density lipoprotein-cholestero( HDL-C) , ap-oprotein AL(Apo-Al) ,apoprotein B(Apo-B) and lipoprotein(a)[LP(a)] were detected in 120 cases of patients with CI(CI group) and 120 non-CI subjects(control group). Results Levels of TC,TG, Apo-B, LP(a) and ox-LDL in CI group were higher than those in control group (P< 0. 01). CIMT of CI group was 1. 1 ± 0. 32 mm, which was higher than 0. 8 ± 0. 54 mm of control group(P< 0. 01). In CI group,TC,TG, LDL-C, Apo-B,LP(a) and ox-LDL were positively correlated with CIMT(P<0. 01) ,but HDL-C and Apo-Al were negatively correlated with CIMT(P<0. 01). Conclusion There could be certain correlation between abnormal lipid metabolism and atherosclerosis in patients with CI. There could be peroxidatic reaction of lipid in patients with CI

  12. Associations between Subclinical Hypothyroidism and Carotid Intima Media Thickness:A Meta Analysis%亚临床甲状腺功能减退与颈动脉内膜中层厚度关系的Meta分析

    Institute of Scientific and Technical Information of China (English)

    王海龙; 张娜; 张文良; 时景璞

    2013-01-01

    目的 综合评价亚临床甲状腺功能减退(SCH)与颈动脉内膜中层厚度(C-IMT)的关系.方法 检索2001年1月-2011年8月发表的有关SCH与C-IMT关系的文献及其参考文献,提取数据并计算加权均数差(WMD)及95%CI,采用Begg′s检验法评价发表偏倚.应用Stata 11.0软件对SCH与C-IMT的关系进行Meta分析.结果 共纳入9篇文献.(1)合并结果显示,SCH组与正常对照组的C-IMT差异有统计学意义[WMD=0.05,95%CI(0.02,0.07)].(2)亚组分析显示,平均年龄<60岁的SCH组与正常对照组比较C-IMT间差异有统计学意义(P<0.05);医院来源的SCH组与正常对照组比较C-IMT 间差异有统计学意义(P<0.05);无论TSH水平<10 mU/L还是TSH水平≥10 mU/L,SCH患者与正常对照者C-IMT间差异均有统计学意义(P<0.05),且TSH水平≥10 mU/L组合并WMD较TSH水平<10 mU/L组合并WMD大.结论 SCH与C-IMT有一定相关性,SCH可能导致颈动脉内膜增厚.%Objective To explore the associations between subclinical hypothyroidism ( SCH ) and carotid intima -media thickness ( C - IMT ). Methods The literatures on associations of SCH and C - IMT published between January 2001 and August 2011 were retrieved in large databases. The data were extracted and the weighted mean difference ( WMD ) and 95% CI were calculated. Publication bias was assessed by Begg's test. Stata 11. 0 was used to perform meta analysis on the associations between SCH and C - IMT. Results A total of nine articles were included in the study. Analysis results showed that C -IMT of SCH patients and normal controls was significantly different [ WMD = 0. 05 , 95% CI ( 0. 02, 0. 07 ) ]. Subgroup analysis showed that C - IMT were significantly different between SCH patients and normal controls in mean age < 60 years old group, and between hospital based SCH patients and normal controls ( P < 0. 05 ). The differences were significant in both TSH level < 10 mU/L and TSH level ≥10 mU/L groups, and the combined

  13. Medición ecográfica del espesor medio-intimal carotídeo en pacientes pediátricos con obesidad, hipercolesterolemia familiar y diabetes tipo 1 Ultrasonography measurement of carotid intima-media thickness in pediatric patients with obesity, familial hypercholesterolemia and type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Mónica Bravo

    2012-03-01

    ínicas preventivas y de orientación terapéutica.To evalúate by ultrasonographic images carotid intima-media thickness (IMT as an early marker of cardiovascular risk (CVR in patients with clinical and laboratory diagnosis of familial hypercholesterolemia (FHC, type 1 diabetes (DBT-1 and Obesity (OB, compared to a healthy control group. Materials and Methods. A prospective, descriptive, and cross-sectional study. We evaluated the IMT of common carotid (ce arteries and included in a single dichotomic variable other structural modifications of the wall (atheromatous plaques and intima irregularities. US was blinded to the blood tests results (as recommended by the 2007 Mannheim consensus from 121 patients (aged 6 to 18 years: 24 FHC, 40 DBT-1, 43 OB, and 14 controls. Patients with other diseases that could alter the arterial wall were excluded. Variables were analyzed using the Statistix 8 program. Results. The three groups had a higher IMT than the control group, with these differences being statistically significant. Mean IMT (mm were 0.59 (0.31-2.15, p: 0.006, CI 0.06 to 0.36 in FHC; 0.48 (0.3-0.85, p: 0.001, CI 0.06-0.14 in obesity; and 0.46 (0.25-0.65, p: 0.0004, CI 0.03-0.13 in DBT-1. Control group: 0.37 (0.30-0.45. The major difference was observed in FHC patients. No association was found between LDL-C valué and IMT Upon the examination, 62.5% were receiving pharmacotherapy. In DBT-1 no association was found between IMT and the levéis of HbAlc and lipids. In the OB group there was no association between IMT and BMI Z-score. Atheromatous plaques and intima irregularities were found in 31% of FHC patients, 8% of DBT-1 patients, and 6% of OB patients. Conclusión. Ultrasonographic IMT measurements demonstrated that patients with chronic diseases and increased CVR at adulthood presented early changes in the carotid intima-media at childhood. This allows clinical prevention strategies and therapeutic guidance.

  14. Endothelial dysfunction, carotid artery plaque burden, and conventional exercise-induced myocardial ischemia as predictors of coronary artery disease prognosis

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    Ishihara Masayuki

    2008-12-01

    Full Text Available Abstract Background While both flow-mediated vasodilation (FMD in the brachial artery (BA, which measures endothelium-dependent vasodilatation, and intima-media thickness (IMT in the carotid artery are correlated with the prognosis of coronary artery disease (CAD, it is not clear which modality is a better predictor of CAD. Furthermore, it has not been fully determined whether either of these modalities is superior to conventional ST-segment depression on exercise stress electrocardiogram (ECG as a predictor. Thus, the goal of the present study was to compare the predictive value of FMD, IMT, and stress ECG for CAD prognosis. Methods and Results A total of 103 consecutive patients (62 ± 9 years old, 79 men with clinically suspected CAD had FMD and nitroglycerin-induced dilation (NTG-D in the BA, carotid artery IMT measurement using high-resolution ultrasound, and exercise treadmill testing. The 73 CAD patients and 30 normal coronary patients were followed for 50 ± 15 months. Fifteen patients had coronary events during this period (1 cardiac death, 2 non-fatal myocardial infarctions, 3 acute heart failures, and 9 unstable anginas. On Kaplan-Meier analysis, only FMD and stress ECG were significant predictors for cardiac events. Conclusion Brachial endothelial function as reflected by FMD and conventional exercise stress testing has comparable prognostic value, whereas carotid artery plaque burden appears to be less powerful for predicting future cardiac events.

  15. Espessamento médio-intimal na origem da artéria subclávia direita como marcador precoce de risco cardiovascular Intima-media thickness in the origin of right subclavian artery as an early marker of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Engelhorn

    2006-11-01

    EMI na origem da artéria subclávia direita pode ser considerado um marcador mais precoce para avaliação de risco cardiovascular.OBJECTIVE: Common carotid artery intima-media thickness (IMT is considered a factor of cardiovascular risk and an early marker of coronary artery disease. This study aimed to investigate the existence of a correlation between IMT in the carotid arteries and at the origin of the right subclavian artery, as well as to evaluate IMT in the subclavian artery as an earlier marker of cardiovascular risk. METHODS: One hundred and six consecutive patients, 52 males and 54 females, average age 51 years, underwent color Doppler ultrasonography to evaluate carotid and right subclavian arteries. The relationship between carotid IMT and right subclavian IMT was assessed using the Pearson's correlation coefficient analysis and a 95% confidence interval. Reliability of right subclavian artery IMT measurement for the diagnosis of early thickening (considering a > 0.8 mm carotid thickness as reference was described as to sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Cut-off values for the right subclavian IMT were indicated by the ROC curve, and p values 0.8 mm. The mean IMT value for the carotid artery was 0.87 mm (SD = 0.23 and for the subclavian artery, 1.17 mm (SD = 0.46, with a 0.31 correlation coefficient (95% CI: 0.12; 0.47. The ROC curve analysis indicated a cut-off value of 0.7 mm for the right subclavian artery IMT, using as reference a 0.8 mm cut-off value for the carotid artery (91% sensitivity, 27% specificity, 66% PPV, 65% NPV, and 66% accuracy. CONCLUSION: Our study showed that carotid artery IMT correlates well with right subclavian artery IMT. With a 0.7 mm cut-off value, it is possible to detect IMT in the right subclavian artery earlier than in the carotid arteries. The IMT at the origin of the right subclavian artery can be considered an earlier marker for the assessment of cardiovascular

  16. 不同种类口服降糖药联用对2型糖尿病患者动脉内膜中层厚度和斑块发生的影响%Effects of combination of antidiabetic agents on artery intima-media thickness and plaque occurrence.

    Institute of Scientific and Technical Information of China (English)

    巴根; 王奇金; 缪雄; 丁长花; 冯正康; 黄勤; 邹大进

    2011-01-01

    目的 探讨不同种类口服降糖药联用对2型糖尿病患者动脉内膜中层厚度(intima-media thickness,IMT)和斑块发生率的影响.方法 选取初发2型糖尿病患者139例(2002年),将患者分为一种、两种、三种口服降糖药物单用组(SING、DOUB、TRIP)和不使用口服降糖药物组(NONE)及对照组.对比分析随访第6年(07年)和第8年(09年)各组颈动脉、髂动脉及股动脉的IMT值与斑块发生率以及其他临床指标的变化情况.结果 (1) TRIP组09年胰岛素(insulin,INS)水平与07相比略有降低.(2)TRIP组09年动脉IMT与07年相比有下降趋势,而对照组动脉IMT值显著升高(P<0.05).(3)TRIP组的动脉斑块发生率低于同期其他各组对应的动脉斑块发生率(P<0.05).(4)口服降糖药物联用种类与动脉斑块发生率具有明显相关性(P<0.05).(5)本研究证明INS是颈动脉斑块发生的危险因子(P<0.05),餐后2h血糖(2hPG)和INS为髂动脉斑块发生的危险因子(P<0.05).结论 罗格列酮+二甲双胍+格列吡嗪三种口服降糖药联用的三联疗法能控制胰岛素升高,延缓甚至逆转脉内膜增厚进程并且能够抑制动脉斑块发生,是较全面的防治2型糖尿病大血管病变的综合疗法.%Objective To investigate the change of artery intima-media thickness ( IMT) and plaque incidence in patients with type 2 diabetic in response to combination of antidiabetic agents. Methods Totally 139 newly diagnosed type 2 diabetic patients (2002) were divided into five groups; single-oral-hypoglycemic-therapy group (SING) ,double-oral-hypoglycemic-therapy group(DOUB) ,triple-oral-hypoglycemic-therapy group(TRIP) , none-oral-hypoglycemic-therapy group( NONE) and control group. The IMT as well as the plaque incidence in carotid artery, femoral artery and iliac artery together with other clinical indicators were measured and compared. Results (1) The INS of TRIP group at 09 slightly decreased compared with that at 07. ( 2 ) The

  17. Growth hormone (GH) and atherosclerosis: changes in morphology and function of major arteries during GH treatment.

    Science.gov (United States)

    Pfeifer, M; Verhovec, R; Zizek, B

    1999-04-01

    Patients with hypopituitarism have increased carotid artery intima-media thickness and reduced arterial distensibility. The effect of 2 years of growth hormone (GH) replacement therapy on these parameters was studied in 11 GH-deficient men (age range, 24-49 years) with hypopituitarism and compared with 12 healthy, age-matched men with no evidence of pituitary or vascular disease. Before treatment the intima-media of the common carotid arteries and the carotid bifurcations were significantly thicker in patients (P < 0.001) than in the control group. Treatment with GH normalized the intima-media thickness of the common carotid artery within 6 months and of the carotid bifurcation within 3 months. The changes in intima-media thickness of the carotid artery were negatively correlated with changes in serum levels of insulin-like growth factor I during treatment. There was a significant improvement in flow-mediated, endothelium-dependent dilation of the brachial artery at 3 months, which was sustained at 6, 18 and 24 months of GH treatment (P < 0.05). Thus, GH replacement therapy in GH-deficient men reverses early morphological and functional atherosclerotic changes in major arteries, and may reduce rates of vascular morbidity and mortality.

  18. Correlation Study of Ankle Brachial Index,Superficial Femoral Artery Intima-media Thickness and the Coronary Heart Disease%踝臂指数及股浅动脉内中-膜厚度与冠心病相关性研究

    Institute of Scientific and Technical Information of China (English)

    应卫华; 李浙成; 胡智星; 童跃锋

    2012-01-01

    目的 探讨踝臂指数(ABI)及股浅动脉内-中膜厚度(IMT)与冠心病相关性.方法 对132例入选对象行冠状动脉造影检查、超声测定股浅动脉IMT及用全自动动脉硬化检测仪检测ABI,并调查年龄、性别、吸烟、血压、家族史、体质指数(BMI)等.用冠状动脉病变血管的数量和GAS积分评价冠脉病变的程度,分析、对比不同病变程度下股浅动脉IMT及ABI.结果 冠心病组股浅动脉IMT明显大于非冠心病组,冠心病组ABI明显小于非冠心病组,差异存在统计学意义,P值均小于0.05;股浅动脉IMT随着冠状动脉病变程度的加重而增加,但冠心病各组间比较无显著差异;ABI随着冠状动脉病变程度的加重而降低,且ABI值在各组间比较,P<0.05,差异具有统计学意义.结论 股浅动脉IMT及ABI与冠心病显著相关.对于冠心病患者,对比股浅动脉IMT与ABI,ABI是更能间接反映冠状动脉病变严重程度的良好指标.%Objective To discuss correlation of the superficial femoral artery intima-media thickness (IMT),ankle brachial index (ABI) and coronary heart disease. Methods .132 cases of hospitalized patients were selected to performed coronary artery angiography and ultrasound measurement of superficial femoral artery intima-media thickness (IMT) and automatic arteriosclerosis detection instrument of ankle brachial index (ABI),and the age, sex,smoking, blood pressure,family history,body weight index (BMI) etc were investigated. With coronary artery lesion volume and GAS integral evaluation of coronary lesion extent,the different extent of lesions of the superficial femoral artery intima-media thickness and ankle brachial index (ABI) were analysed. Results The superficial femoral artery intima-media thickness of coronary heart disease group was significantly greater than that of non-CHD group; ankle brachial index (ABI)was significantly lower than that of non-CHD group,there were statistically significant difference

  19. Spontaneous internal carotid artery dissection.

    Science.gov (United States)

    Khimenko, L P; Esham, H R; Ahmed, W

    2000-10-01

    Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

  20. Wall irregularity rather than intima-media thickness is associated with nearby atherosclerosis.

    Science.gov (United States)

    Graf, Iulia M; Schreuder, Floris H B M; Hameleers, Jeroen M; Mess, Werner H; Reneman, Robert S; Hoeks, Arnold P G

    2009-06-01

    In addition to intima-media thickness (IMT), IMT inhomogeneity may carry information about atherosclerosis progression. In 147 vascular diseased patients (mean 66 y, 48% male), we determined the carotid bulb stenosis degree based on local Doppler blood flow velocities. Common carotid artery (CCA) morphologic characteristics, i.e. IMT, IMT-inhomogeneity (intraregistration variation) and IMT uni- and bilateral intrasubject variation (DeltaIMT), were measured using multiple M-mode. Associations of morphologic characteristics, stenosis degree and Framingham score were evaluated with Pearson correlation (r) and multiple regression analysis. The IMT distributions for subjects without and with stenosis were not similar. The stenosis degree score correlated significantly to unilateral (r=0.68) and bilateral DeltaIMT (r=0.62), IMT (r=0.41) and IMT-inhomogeneity (r=0.45). The averaged IMT and IMT-inhomogeneity increased slightly for singular stenosis and abruptly for multiple stenoses. Mean uni- and bilateral DeltaIMT per stenosis degree increased linearly with this degree, reaching a correlation close to 1 (r=0.98 and r=0.97). Interestingly, the majority of the subjects with a moderate to severe bulb stenosis exhibited a carotid IMT lower than the considered critical threshold of 0.9 mm. In conclusion, although CCA is not prone to plaques, its morphologic characteristics are positively correlated with stenosis degree score and other risk scores. DeltaIMT can be more reliable derived from inter-registration rather than from intra-registration variation. In the CCA, DeltaIMT substantiates vascular alteration better than IMT.

  1. Carotid Artery Disease

    Science.gov (United States)

    ... make them more vulnerable to damage. Tobacco use. Nicotine can irritate the inner lining of your arteries. ... your physical and mental capabilities such as strength, memory and speech. After that, your doctor may recommend: ...

  2. High resolution ultrasound and arterial wall changes in early atherosclerosis

    Science.gov (United States)

    Renton, Sophie Caroline

    Non-invasive vascular testing evolved initially to meet the needs of the surgeon to identify haemodynamically significant lesions. However, with refinement of techniques and the development of high resolution ultrasound, it has become possible to detect early lesions and to measure the thickness of die arterial wall with an accuracy of 0.2mm. Such measurements have epidemiological and prognostic potential. They may allow the study of progression (or regression) of atherosclerotic disease before symptoms develop. The aim of this thesis was to assess the value of arterial wall measurements of intima-media thickness and compliance of the common carotid artery in the prediction of early atherosclerotic disease. Four different anatomical patterns of carotid bulb morphology have been identified, according to the position of the bulb origin in relation to the flow divider. It has been demonstrated that bulb morphology influences the site of early plaque formation. The presence of plaque at the carotid and femoral bifurcations was found to be associated with increased intima-media thickening of the common carotid artery. Histological analysis of common carotid arteries taken at post-mortem showed that this diffuse intima-media thickening is the result of deposition of cholesterol crystals, medial atrophy, fatty and fibrous change, and accumulation of necrotic debris, the features characteristic of plaques, even though discrete plaques rarely occur at this site. Subsequently, a number of clinical studies were undertaken which demonstrated that the intima-media thickness is increased in diabetics, hypopituitary patients and claudicants as compared to controls. It was found that the intima-media thickness of the common carotid artery could be used to predict the presence of bifurcation plaques and macrovascular disease. The work of this thesis has demonstrated that high resolution ultrasound is a powerful technique for die study of the arterial wall and should be tested in

  3. General principles of carotid Doppler ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Whal [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    Carotid Doppler ultrasonography is a popular tool for evaluating atherosclerosis of the carotid artery. Its two-dimensional gray scale can be used for measuring the intima-media thickness, which is very good biomarker for atherosclerosis and can aid in plaque characterization. The plaque morphology is related to the risk of stroke. The ulceration of plaque is also known as one of the strong predictors of future embolic event risk. Color Doppler ultrasonography and pulse Doppler ultrasonography have been used for detecting carotid artery stenosis. Doppler ultrasonography has unique physical properties. The operator should be familiar with the physics and other parameters of Doppler ultrasonography to perform optimal Doppler ultrasonography studies.

  4. Anomalous external carotid artery-internal carotid artery anastomosis in two patients with proximal internal carotid arterial remnants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Hun [Dept. of Neurology, Stroke Center, Myongji Hospital, Goyang (Korea, Republic of); Cho, Young Dae; Kang, Hyun Seung; Kim, Jeong Eun; Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Seung Chai [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Ahn, Jun Hyong [Dept. of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

    2015-08-15

    Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other.

  5. Carotid artery stenting : a 2009 update

    NARCIS (Netherlands)

    Zeebregts, Clark J.; Meerwaldt, Robbert; Geelkerken, Robert H.

    2009-01-01

    Purpose of review Carotid endarterectomy (CEA) is is still considered the gold standard in the treatment of patients with significant carotid stenosis and has proven its value over the past decades. Endovascular techniques have evolved, and carotid artery stenting (CAS) is challenging CEA to become

  6. Effect of 3 y of folic acid supplementation on the progression of carotid intima-media thickness and carotid arterial stiffness in older adults

    NARCIS (Netherlands)

    Durga, Jane; Bots, Michiel L.; Schouten, Evert G.; Grobbee, Diederick E.; Kok, Frans J.; Verhoef, Petra

    2011-01-01

    Background: Observational studies have shown that low folate and elevated homocysteine concentrations are risk factors for vascular disease in the general population. Randomized controlled trials in vascular patients have failed to show that folic acid reduces the risk of recurrent vascular disease,

  7. 维持性血液透析患者微炎症状态与颈动脉内中膜厚度进展的相关性研究%Correlation between the micro-inflammatory state of maintenance hemodialysis patients and progression of carotid intima-media thickness

    Institute of Scientific and Technical Information of China (English)

    张晓东; 张建荣; 朱愿; 宋洁; 李瑛; 李辉

    2012-01-01

    Objective To explore the correlation between the micro - inflammatory state of patients of maintenance hemodialy-sis and progression of carotid intima - media thickness ( PROG - IMT) . Methods The high - sensitivity C - reactive protein level ( hs - CRP) of 93 standard - compliant MHD patients was measured by ELISA. According to the results, these patients were divided into normal group (30 cases, hs - CRP levels 0.05). There was one death from cardiovascular and cerebrovascular diseases. (2) PROG - IMT, hs - CRP, age, blood pressure, and low density lipoprotein were positively correlated (P 0.05);因心脑血管疾病死亡1例.(2)PROG-IMT 与hs-CRP、年龄、血压、低密度脂蛋白正相关(P<0.05).(3)多元逐步回归分析显示,hs-CRP 是影响PROG-IMT 的主要因素(P<0.05).结论 微炎症状态MHD 患者IMT 呈进行性进展,血清hs-CRP 水平是影响PROG-IMT 的主要因素.

  8. Medical treatment in carotid artery intervention

    NARCIS (Netherlands)

    Kolkert, J. L.; Meerwaldt, R.; Lefrandt, Johan; Geelkerken, R. H.; Zeebregts, C. J.

    2011-01-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical the

  9. Association of circulating omentin-1 level with arterial stiffness and carotid plaque in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Yoo Hye

    2011-11-01

    Full Text Available Abstract Background Adipokines contribute directly to the atherosclerotic process, connecting metabolic disorders such as obesity and diabetes to cardiovascular disease. Omentin-1 is a recently discovered novel adipokine, so data about the relationship of this adipokine to vascular health in type 2 diabetes is limited. Methods We enrolled 60 people with type 2 diabetes, with or without carotid plaque, and 30 participants with normal glucose tolerance. We measured serum omentin-1, high-sensitivity C-reactive protein (hsCRP levels, and the homeostasis model assessment of insulin resistance (HOMA-IR, as well as other cardiovascular risk factors. Vascular health was assessed by brachial ankle pulse wave velocity (baPWV and carotid intima-media thickness (IMT. Results Serum omentin-1 levels were significantly decreased in type 2 diabetes patients compared to normal glucose controls and was further reduced in type 2 diabetes patients with carotid plaque compared to those without carotid plaque. Multiple stepwise regression analysis showed that age, systolic blood pressure, history of use of statins, angiotensin receptor blockers or angiotensin-converting enzyme inhibitors, and serum omentin-1 level were independent factors determining baPWV in people with type 2 diabetes (r2 = 0.637. Furthermore, in multivariate logistic regression analysis, circulating omentin-1 level was an independent decisive factor for the presence of carotid plaque in type 2 diabetes patients, even after adjusting for age, gender, body mass index, systolic blood pressure, fasting blood glucose, low density lipoprotein cholesterol, and history of smoking and medication (odds ratio, 0.621; 95% confidence interval, 0.420-0.919; P = 0.017. Conclusions Circulating omentin-1 level was independently correlated with arterial stiffness and carotid plaque in type 2 diabetes, even after adjusting for other cardiovascular risk factors and detailed medication history.

  10. Sonographic assessment of carotid artery in postmenopausal women receiving long-term low-dose hormone replacement therapy

    Institute of Scientific and Technical Information of China (English)

    Wang Hong-yan; Jiang Yu-xin; Meng Hua; Ge Qin-sheng

    2004-01-01

    Objective: The aim of this study was to determine the influence of long-term low-dose hor mone replacement therapy (HRT) on the intima-media wall of the carotid artery in postmenopa usal women by ultrasound.Methods: 146 postmenopausal women were divided into the HRT group(n= 68, HRT over 5years after menopause) and the control group(n= 78, no HRT). The intima-media thickness (IMT) of the carotid arteries was measured bilaterally, the characteristics of the atherosclerotic plaques were described, the peak systolic velocity (PSV) and resistance index (RI) were measured by ultrasound examination.Results: The IMT of HRT group was significantly smaller than that of the control group,(0. 089±0. 22) cm vs (0. 093±0.29) cm, (P<0. 01). The occurrence of plaques was reduced in HRT group than the control group (7.7% vs 12.7%, P<0. 05). The plaques were most frequently found at the bifurcation of the arteries. The soft and mixed plaques in HRT group were found significantly less than that of the control group (soft 1.7% vs 4. 5%, mixed 3.1% vs 6. 7%, both P<0.05), while the hard plaques in HRT group were more than those of the control group(2.6% vs 1.3%, P<0. 05). The maximum plaque thickness of HRT group was less than that of control group (0. 191±0. 057) cm vs (0. 226±0. 073) cm, (P<0.05). The internal carotid artery PSV and RI in the two groups were similar [PSV (65.61±26.55) cm/s vs (64.82±27. 22) cm/s, RI (0.67±0. 082) vs (0. 68±0. 075), both P>0.05].Conclusion: Our study indicated that HRT may has an effect to reduce the carotid IMT thickness, inhibit the plaque formation, and make the plaques harder and more stable. The long-term low-dose HRT may protect the postmenopausal women against the artherosclerosis of the carotid artery.

  11. Measurement of arterial wall thickness as a surrogate marker for atherosclerosis

    NARCIS (Netherlands)

    de Groot, E; Hovingh, GK; Wiegman, A; Duriez, P; Smit, AJ; Fruchart, JC; Kastelein, JJP

    2004-01-01

    Large observational studies and atherosclerosis regression trials of lipid-modifying pharmacotherapy have established that intima-media thickness of the carotid and femoral arteries, as measured noninvasively by B-mode ultrasound, is a valid surrogate marker for the progression of atherosclerotic di

  12. Intima media thickness measurement in children: A statement from the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology.

    Science.gov (United States)

    Dalla Pozza, Robert; Ehringer-Schetitska, Doris; Fritsch, Peter; Jokinen, Eero; Petropoulos, Andreas; Oberhoffer, Renate

    2015-02-01

    Atherosclerosis causing cardiovascular disease is the most common cause of death in the developed world. Early precursors of vascular changes - subclinical atherosclerosis - warrant special attention as this process can be stabilized or even reversed if treated in time. Sonographic Intima Media Thickness measurement of the carotid artery (cIMT: carotid Intima-Media-Thickness) is considered a valid surrogate marker for cardiovascular risk allowing assessment of atherosclerotic changes at a very early stage. It is easy to apply due to its non-invasive character. Moreover, cIMT has been proven to provide reliable and reproducible results both in adult and adolescent patients. For the paediatric age group, several characteristics deserve special consideration. The heterogeneity of techniques of scanning, measurement and interpretation impede the comparison and interpretation of IMT values so far. Also, age- and sex-dependent normative data have to be considered for interpretation. Thus, the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention concludes to refer a statement on cIMT scanning, measurement and interpretation with special focus on paediatric patients. This statement includes an overview on normative data available as well as a practical guideline for the setting, scanning, measurement and interpretation of IMT values. Synchronizing different measurement methods will allow for comparing the results of several research centers. By that, in a large patient number, sufficient information may be given to assess the long-term endpoints of cardiovascular morbidity and mortality.

  13. 肥胖中青年男性颈动脉内中膜厚度相关危险因素分析%Analysis of the Related Risk Factors of Carotid Intima-media Thickness in Middle-age and Young Men with Obesity

    Institute of Scientific and Technical Information of China (English)

    杨青; 陆强; 刘晓丽

    2013-01-01

    [目的]探讨肥胖中青年男性人群颈动脉内中膜厚度(CIM T )的相关危险因素。[方法]选取81例20~50岁男性为研究对象。根据体质量指数(BM I)分为肥胖组28例(BM I >28 kg/m2)、超重组25例(BM I=25~28 kg/m2)和对照组28例( BM I<25 kg/m2)三组。检测三组的血糖、血脂、尿酸(U A )、睾酮(T )、胰岛素抵抗指数及人体基本参数。[结果]中青年男性肥胖组BMI、收缩压(SBP)、甘油三脂(TG)、总胆固醇(TC)、UA、胰岛素抵抗指数(HOMA-IR)均高于超重组及对照组( P <0.05),与CIMT正相关,高密度脂蛋白胆固醇(HDL-C)、T低于超重组及对照组( P <0.05),与IMT呈负相关。多元线性回归显示BMI、TG是颈动脉内中膜异常的相关独立危险因素。[结论]肥胖组中青年男性存在CIMT增厚。BMI及TG是CIMT独立危险因素。%[Objective]To explore the related risk factors of carotid intima-media thickness(CIMT) in middle-age and young men with obesity .[Methods]Totally 81 men aged 20~50 years were enrolled in the study .Accord-ing to body mass index(BMI) ,all subjects were divided into obese group( n =28 ,BMI>28 kg/m2 ) ,overweight group( n=25 ,BMI=25~28 kg/m2 ) and control group( n=28 ,BMI<25 kg/m2 ) .Blood sugar ,lipids ,uric acid (UA) ,testosterone(T) ,insulin resistance index (HOMA-IR) and anthropometric parameters of 3 groups were measured .[Results]BMI ,SBP ,TG ,TC ,UA and HOMA-IR in middle-age and young obesity group were higher than those in overweight group and control group( P <0 .05) ,and positively correlated with CIMT .HDL-C and T in middle-age and young obesity group were lower than those in overweight group and control group ( P <0 .05) ,and negatively correlated with IMT .Multivariant linear regression analysis showed that BMI and TG were the relative independent risk factors of abnormal carotid intima-media .[Conclusion]CIM T in middle-age and young men

  14. Serum Levels of Anticyclic Citrullinated Peptide Antibodies, Interleukin-6, Tumor Necrosis Factor-α, and C-Reactive Protein Are Associated with Increased Carotid Intima-Media Thickness: A Cross-Sectional Analysis of a Cohort of Rheumatoid Arthritis Patients without Cardiovascular Risk Factors

    Directory of Open Access Journals (Sweden)

    Mónica Vázquez-Del Mercado

    2015-01-01

    Full Text Available The main cause of death in rheumatoid arthritis (RA is cardiovascular events. We evaluated the relationship of anticyclic citrullinated peptide (anti-CCP antibody levels with increased carotid intima-media thickness (cIMT in RA patients. Methods. Forty-five anti-CCP positive and 37 anti-CCP negative RA patients, and 62 healthy controls (HC were studied. All groups were assessed for atherogenic index of plasma (AIP and cIMT. Anti-CCP, C-reactive protein (CRP, and levels of tumor necrosis factor alpha (TNFα and interleukin-6 (IL-6 were measured by enzyme-linked immunosorbent assay (ELISA. Results. The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative (P<0.001. Anti-CCP positive versus anti-CCP negative RA patients, had increased AIP, TNFα and IL-6 (P<0.01, and lower levels of high density lipoprotein cholesterol (HDL-c (P=0.02. The cIMT correlated with levels of anti-CCP (r=0.513, P=0.001, CRP (r=0.799, P<0.001, TNFα (r=0.642, P=0.001, and IL-6 (r=0.751, P<0.001. In multiple regression analysis, cIMT was associated with CRP (P<0.001 and anti-CCP levels (P=0.03. Conclusions. Levels of anti-CCP and CRP are associated with increased cIMT and cardiovascular risk supporting a clinical role of the measurement of cIMT in RA in predicting and preventing cardiovascular events.

  15. Serum Levels of Anticyclic Citrullinated Peptide Antibodies, Interleukin-6, Tumor Necrosis Factor-α, and C-Reactive Protein Are Associated with Increased Carotid Intima-Media Thickness: A Cross-Sectional Analysis of a Cohort of Rheumatoid Arthritis Patients without Cardiovascular Risk Factors

    Science.gov (United States)

    Vázquez-Del Mercado, Mónica; Nuñez-Atahualpa, Lourdes; Figueroa-Sánchez, Mauricio; Gómez-Bañuelos, Eduardo; Rocha-Muñoz, Alberto Daniel; Martín-Márquez, Beatriz Teresita; Martínez-García, Erika Aurora; Macias-Reyes, Héctor; Gamez-Nava, Jorge Ivan; Navarro-Hernandez, Rosa Elena; Nuñez-Atahualpa, María Alejandra; Andrade-Garduño, Javier

    2015-01-01

    The main cause of death in rheumatoid arthritis (RA) is cardiovascular events. We evaluated the relationship of anticyclic citrullinated peptide (anti-CCP) antibody levels with increased carotid intima-media thickness (cIMT) in RA patients. Methods. Forty-five anti-CCP positive and 37 anti-CCP negative RA patients, and 62 healthy controls (HC) were studied. All groups were assessed for atherogenic index of plasma (AIP) and cIMT. Anti-CCP, C-reactive protein (CRP), and levels of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA). Results. The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative (P < 0.001). Anti-CCP positive versus anti-CCP negative RA patients, had increased AIP, TNFα and IL-6 (P < 0.01), and lower levels of high density lipoprotein cholesterol (HDL-c) (P = 0.02). The cIMT correlated with levels of anti-CCP (r = 0.513, P = 0.001), CRP (r = 0.799, P < 0.001), TNFα (r = 0.642, P = 0.001), and IL-6 (r = 0.751, P < 0.001). In multiple regression analysis, cIMT was associated with CRP (P < 0.001) and anti-CCP levels (P = 0.03). Conclusions. Levels of anti-CCP and CRP are associated with increased cIMT and cardiovascular risk supporting a clinical role of the measurement of cIMT in RA in predicting and preventing cardiovascular events. PMID:25821796

  16. Effect of Pioglitazone Compared With Glimepiride on Carotid Intima-Media Thickness in Type 2 Diabetes A Randomized Trial%格列美脲与匹格列酮对2型糖尿病患者颈动脉内膜中层厚度影响的比较研究随机试验

    Institute of Scientific and Technical Information of China (English)

    Theodore Mazzone; 胡与; Peter M. Meyer; Steven B. Feinstein; Michael H. Davidson; George T. Kondos; Ralph B. D' Agostino; Alfonsp Perez; Jean-Claude Provost; Steven M. Haffner

    2007-01-01

    背景:颈动脉内膜中层厚度(carotid artery intima-media thickness,CIMT)是冠状动脉粥样硬化的一种标志物,可以独立地预测心血管事件的发生.2型糖尿病患者心血管事件有所增加.尽管相对短期的研究显示,噻唑烷二酮类药物(例如匹格列酮)可以减缓CIMT的进展,但是长期研究结果目前尚不明确.目的:与格列美脲比较,评估匹格列酮对2型糖尿病患者颈总动脉CIMT变化的影响.设计、地点及参试者:2003年10月至2006年5月于芝加哥城区28家临床单位收治的2型糖尿病患者中进行随机、双盲、对照、多中心试验.治疗期为72周(随访1周).在每个中心由一位超声检查操作者采集CIMT影像,由一位不了解治疗分组情况的判读者应用自动边缘检测技术进行判读.462例2型糖尿病成人患者(平均年龄,60[SD,8.1]岁;平均体重指数,32[SD,5.1];平均病程7.7[SD,7.2]年;平均糖化血红蛋白值[HbA1c],7.4%[SD,1.0%])或者为新近确诊,或者为目前已接受饮食/锻炼、磺酰脲类、二甲双胍、胰岛素或联合治疗的患者.干预:盐酸匹格列酮(15~45 mg/d)和作为有效比较的格列美脲(1~4 mg/d).主要观测指标:与基线比较,最后随访时左右两侧颈总动脉后壁平均CIMT的绝对变化.结果:与格列美脲比较,各时点(24、48、72周)匹格列酮组CIMT的平均变化较小.72周时,匹格列酮组与格列美脲组比较,平均CIMT进展一级终点较小(分别为-0.001 mm 和+0.012 mm;差别为-0.013 mm;95%可信区间,-0.024至-0.002;P=0.02).与格列美脲比较,匹格列酮还可减缓最大CIMT进展(72周时分别为0.002 mm和0.026 mm;差别为-0.024 rain;95%可信区间,-0.042至-0.006;P=0.008).在根据年龄、性别、收缩压、DM:病程、体重指数、HbA1c值以及他汀类药物使用预先确定的各亚组问,匹格列酮对平均CIMT的有益效应相似.结论:与格列美脲比较,在为期18个月的治疗期间,匹格列酮减缓了2型糖尿病患者CIMT的进展.

  17. Carotid artery stenting in patients with coexistent carotid and coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    LUO Jian-fang; HUANG Wen-hui; WANG Shuo; DAI Cheng-bo; LI Guang; CHEN Ji-yan; ZHOU Ying-ling; WANG Li-juan

    2007-01-01

    @@ Atherosclerotic disease, as a systemic process, affects all arteries to varying degrees. In particular,coexistent carotid and coronary artery diseases are common; Management of such patients has been a point of continuing controversy.

  18. Breast arterial calcification and risk of carotid atherosclerosis: Focusing on the preferentially affected layer of the vessel wall

    Energy Technology Data Exchange (ETDEWEB)

    Sedighi, Nahid, E-mail: nsedighi@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmard, Amir Reza, E-mail: radmard@ams.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmehr, Ali, E-mail: radmehr@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hashemi, Pari, E-mail: phtums@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hajizadeh, Abdolmahmoud, E-mail: mroomezi@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Taheri, Amir Pejman Hashemi, E-mail: hashemip@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of)

    2011-08-15

    Objective: To assess the relationship between breast arterial calcification (BAC) detected on screening mammography and atherosclerosis of carotid arteries considering the most likely involved layer of the arterial wall. Materials and methods: A total of 537 consecutive women who underwent screening mammography were enrolled in this study. Seventy-nine subjects having BAC, aged 46-75 years, and 125 age-matched controls from those without BAC were selected for ultrasound examination of carotid arteries assessing intima-media thickness (IMT) and plaque presence. Participants were divided into three groups of risk including, low-risk: IMT < 0.6 mm without plaque, medium-risk: 0.6 mm {<=} IMT {<=} 0.8 mm without plaque and high-risk: IMT > 0.8 mm and/or plaque. Risk factors for atherosclerosis were obtained from medical records for independent effects. Results: BAC was present in 14.7% of mammograms. According to multivariable logistic regression analyses, significant association was identified between the carotid atherosclerosis risk and presence of BAC. Compared to women with IMT < 0.6 mm, those with 0.6 mm {<=} IMT{<=} 0.8 mm and IMT > 0.8 mm had OR (95% CI) of 4.88 (1.47-16.16) and 23.36 (4.54-120.14), respectively. The OR (95% CI) for carotid plaque was 3.13 (1.3-7.57). There was no interaction between IMT category and plaque. Significant associations were also detected with postmenopausal duration (P = 0.02) and hypertension (P = 0.004). Conclusion: The risk of carotid atherosclerosis increases with the presence of BAC. Women with BAC are more likely to have thicker IMT than plaque, which could be attributed to the preferentially similar affected layer of media causing thick IMT rather than plaque.

  19. Selection of treatment for patients with carotid artery disease: medication, carotid endarterectomy, or carotid artery stenting.

    Science.gov (United States)

    Bosiers, Marc; Peeters, Patrick; Deloose, Koen; Verbist, Jürgen; Sprouse, Richard L

    2005-01-01

    Patients presenting with atherosclerosis of the extracranial carotid arteries may be offered carotid endarterectomy (CEA), carotid artery stenting (CAS), or medical therapy to reduce their risk of stroke. In many cases, the choice between treatment modalities remains controversial. An algorithm based on patients' neurologic symptoms, comorbidities, limiting factors for CAS and CEA, and personal preferences was developed to determine the optimal treatment in each case. This algorithm was then employed to determine therapy in 308 consecutive patients presenting to a single institution during one calendar year. Ninety-five (30.8%) patients presented with an asymptomatic carotid stenosis of more than 80% and 213 (69.2%) with a symptomatic stenosis of more than 50%. According to our algorithm, 59 (62.1%) of the 95 asymptomatic patients received CAS, 20 (21.1%) received CEA, and 16 (16.8%) received medical therapy. All symptomatic patients underwent intervention; 153 (71.8%) were treated with CAS and 60 (28.2%) with CEA. Combined 30-day stroke and death rates after CAS were 1.7% in asymptomatic patients and 2.6% in symptomatic patients. After CEA, these rates were 0% and 3.3%, respectively. Careful selection of treatment modality according to predetermined criteria can result in improved outcomes.

  20. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study) : an interim analysis of a randomised controlled trial

    NARCIS (Netherlands)

    Ederle, Joerg; Dobson, Joanna; Featherstone, Roland L.; Bonati, Leo H.; van der Worp, H. Bart; de Borst, Gert J.; Lo, T. Hauw; Gaines, Peter; Dorman, Paul J.; Macdonald, Sumaira; Lyrer, Philippe A.; Hendriks, Johanna M.; McCollum, Charles; Nederkoorn, Paul J.; Brown, Martin M.; Algra, A.; Bamford, J.; Beard, J.; Bland, M.; Bradbury, A. W.; Brown, M. M.; Clifton, A.; Gaines, P.; Hacke, W.; Halliday, A.; Malik, I.; Mas, J. L.; McGuire, A. J.; Sidhu, P.; Venables, G.; Bradbury, A.; Brown, M. M.; Clifton, A.; Gaines, P.; Collins, R.; Molynewc, A.; Naylor, R.; Warlow, C.; Ferro, J. M.; Thomas, D.; Bonati, L. H.; Coward, L.; Dobson, J.; Ederle, J.; Featherstone, R. F.; Tindall, H.; McCabe, D. J. H.; Wallis, A.; Brooks, M.; Chambers, B.; Chan, A.; Chu, P.; Clark, D.; Dewey, H.; Donnan, G.; Fell, G.; Hoare, M.; Molan, M.; Roberts, A.; Roberts, N.; Beiles, B.; Bladin, C.; Clifford, C.; Fell, G.; Grigg, M.; New, G.; Bell, R.; Bower, S.; Chong, W.; Holt, M.; Saunder, A.; Than, P. G.; Gett, S.; Leggett, D.; McGahan, T.; Quinn, J.; Ray, M.; Wong, A.; Woodruff, P.; Foreman, R.; Schultz, D.; Scroop, R.; Stanley, B.; Allard, B.; Atkinson, N.; Cambell, W.; Davies, S.; Field, P.; Milne, P.; Mitchell, P.; Tress, B.; Yan, B.; Beasley, A.; Dunbabin, D.; Stary, D.; Walker, S.; Cras, P.; d'Archambeau, O.; Hendriks, J. M. H.; Van Schil, P.; Bosiers, M.; Deloose, K.; van Buggenhout, E.; De Letter, J.; Devos, V.; Ghekiere, J.; Vanhooren, G.; Astarci, P.; Hammer, F.; Lacroix, V.; Peeters, A.; Verhelst, R.; DeJaegher, L.; Peeters, A.; Verbist, J.; Blair, J-F; Caron, J. L.; Daneault, N.; Giroux, M-F; Guilbert, F.; Lanthier, S.; Lebrun, L-H; Oliva, V.; Raymond, J.; Roy, D.; Soulez, G.; Weill, A.; Hill, M.; Hu, W.; Hudion, M.; Morrish, W.; Sutherland, G.; Wong, J.; Alback, A.; Harno, H.; Ijas, P.; Kaste, M.; Lepantalo, M.; Mustanoja, S.; Paananen, T.; Porras, M.; Putaala, J.; Railo, M.; Sairanen, T.; Soinne, L.; Vehmas, A.; Vikatmaa, P.; Goertler, M.; Halloul, Z.; Skalej, M.; Brennan, P.; Kelly, C.; Leahy, A.; Moroney, J.; Thornton, J.; Koelemay, M. J. W.; Nederkoorn, P. J.; Reekers, J. A. A.; Roos, Y. B. W. E. M.; Hendriks, J. M.; Koudstaal, P. J.; Pattynama, P. M. T.; van der Lugt, A.; van Dijk, L. C.; van Sambeek, M. R. H. M.; van Urk, H.; Verhagen, H. J. M.; Bruininckx, C. M. A.; de Bruijn, S. F.; Keunen, R.; Knippenberg, B.; Mosch, A.; Treurniet, F.; van Dijk, L.; van Overhagen, H.; Wever, J.; de Beer, F. C.; van den Berg, J. S. P.; van Hasselt, B. A. A. M.; Zeilstra, D. J.; Boiten, J.; van Otterloo, J. C. A. de Mol; de Vries, A. C.; Nieholt, G. J. Lycklama A.; van der Kallen, B. F. W.; Blankensteijn, J. D.; De Leeuw, F. E.; Kool, L. J. Schultze; van der Vliet, J. A.; de Borst, G. J.; de Kort, G. A. P.; Kapelle, L. J.; Lo, T. H.; Mali, W. P. Th M.; Moll, F.; van der Worp, H. Bart; Verhagen, H.; Barber, P. A.; Bourchier, R.; Hill, A.; Holden, A.; Stewart, J.; Bakke, S. J.; Krohg-Sorensen, K.; Skjelland, M.; Tennoe, B.; Bialek, P.; Biejat, Z.; Czepiel, W.; Czlonkowska, A.; Dowzenko, A.; Jedrzejewska, J.; Kobayashi, A.; Lelek, M.; Polanski, J.; Kirbis, J.; Milosevic, Z.; Zvan, B.; Blasco, J.; Chamorro, A.; Macho, J.; Obach, V.; Riambau, V.; San Roman, L.; Branera, J.; Canovas, D.; Estela, Jordi; Gimenez Gaibar, A.; Perendreu, J.; Bjorses, K.; Gottsater, A.; Ivancev, K.; Maetzsch, T.; Sonesson, B.; Berg, B.; Delle, M.; Formgren, J.; Gillgren, P.; Kall, T-B; Konrad, P.; Nyman, N.; Takolander, R.; Andersson, T.; Malmstedt, J.; Soderman, M.; Wahlgren, C.; Wahlgren, N.; Binaghi, S.; Hirt, L.; Michel, P.; Ruchat, P.; Bonati, L. H.; Engelter, S. T.; Fluri, F.; Guerke, L.; Jacob, A. L.; Kirsch, E.; Lyrer, P. A.; Radue, E-W; Stierli, P.; Wasner, M.; Wetzel, S.; Bonvin, C.; Kalangos, A.; Lovblad, K.; Murith, N.; Ruefenacht, D.; Sztajzel, R.; Higgins, N.; Kirkpatrick, P. J.; Martin, P.; Adam, D.; Bell, J.; Bradbury, A. W.; Crowe, P.; Gannon, M.; Henderson, M. J.; Sandler, D.; Shinton, R. A.; Scriven, J. M.; Wilmink, T.; D'Souza, S.; Egun, A.; Guta, R.; Punekar, S.; Seriki, D. M.; Thomson, G.; Brennan, A.; Enevoldson, T. P.; Gilling-Smith, G.; Gould, D. A.; Harris, P. L.; McWilliams, R. G.; Nasser, H-C; White, R.; Prakash, K. G.; Serracino-Inglott, F.; Subramanian, G.; Symth, J. V.; Walker, M. G.; Clarke, M.; Davis, M.; Dixit, S. A.; Dolman, P.; Dyker, A.; Ford, G.; Golkar, A.; Jackson, R.; Jayakrishnan, V.; Lambert, D.; Lees, T.; Louw, S.; Macdonald, S.; Mendelow, A. D.; Rodgers, H.; Rose, J.; Stansby, G.; Wyatt, M.; Baker, T.; Baldwin, N.; Jones, L.; Mitchell, D.; Munro, E.; Thornton, M.; Baker, D.; Davis, N.; Hamilton, G.; McCabe, D.; Platts, A.; Tibballs, J.; Beard, J.; Cleveland, T.; Dodd, D.; Gaines, P.; Lonsdale, R.; Nair, R.; Nassef, A.; Nawaz, S.; Venables, G.; Belli, A.; Clifton, A.; Cloud, G.; Halliday, A.; Markus, H.; McFarland, R.; Morgan, R.; Pereira, A.; Thompson, A.; Chataway, J.; Cheshire, N.; Gibbs, R.; Hammady, M.; Jenkins, M.; Malik, I.; Wolfe, J.; Adiseshiah, M.; Bishop, C.; Brew, S.; Brookes, J.; Brown, M. M.; Jaeger, R.; Kitchen, N.; Ashleigh, R.; Butterfield, S.; Gamble, G. E.; McCollum, C.; Nasim, A.; O'Neill, P.; Wong, J.; Edwards, R. D.; Lees, K. R.; MacKay, A. J.; Moss, J.; Rogers, P.

    2010-01-01

    Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid

  1. The effect of long-term homocysteine-lowering on carotid intima-media thickness and flow-mediated vasodilation in stroke patients: a randomized controlled trial and meta-analysis

    Directory of Open Access Journals (Sweden)

    Green Daniel J

    2008-09-01

    Full Text Available Abstract Background Experimental and epidemiological evidence suggests that homocysteine (tHcy may be a causal risk factor for atherosclerosis. B-vitamin supplements reduce tHcy and improve endothelial function in short term trials, but the long-term effects of the treatment on vascular structure and function are unknown. Methods We conducted a sub-study of VITATOPS, a randomised, double-blind, placebo-controlled intervention trial designed to test the efficacy of long term B-vitamin supplementation (folic acid 2 mg, vitamin B6 25 mg and vitamin B12 0.5 mg in the prevention of vascular events in patients with a history of stroke. We measured carotid intima-medial thickness (CIMT and flow-mediated dilation (FMD at least two years after randomisation in 162 VITATOPS participants. We also conducted a systematic review and meta-analysis of studies designed to test the effect of B-vitamin treatment on CIMT and FMD. Results After a mean treatment period of 3.9 ± 0.9 years, the vitamin-treated group had a significantly lower mean plasma homocysteine concentration than the placebo-treated group (7.9 μmol/L, 95% CI 7.5 to 8.4 versus 11.8 μmol/L, 95% CI 10.9 to 12.8, p Conclusion Although short-term treatment with B-vitamins is associated with increased FMD, long-term homocysteine-lowering did not significantly improve FMD or CIMT in people with a history of stroke. Trial Registration Clinical Trial Registration URL: http://www.actr.org.au/ Trial Registration number: 12605000005651

  2. Smoking status and common carotid artery intima-medial thickness among middle-aged men and women based on ultrasound measurement: a cohort study

    Directory of Open Access Journals (Sweden)

    Merz C Noel

    2006-10-01

    Full Text Available Abstract Background Cigarette smoking is an established causal factor for atherosclerosis. However, the smoking effect on different echogenic components of carotid arterial wall measured by ultrasound is not well elucidated. Methods Middle-aged men and women who had IMT measurement ≥ 0.7 mm at baseline and follow-up were included (N = 413, age 40–60 years at baseline in 1995. Intima-media thickness of common carotid artery (CCA-IMT and its components (echogenic and echolucent layers were measured at baseline and in the follow-up examination 3 years later. IMT and its components were compared across current, former and never smokers. Individual growth models were used to examine how smoking status was related to the baseline and progression of overall IMT and IMT components. Results For both men and women, current smoking was associated with thicker echogenic layer than never smokers; former smokers exhibited thinner echogenic layer than current smokers after adjustment for cigarette pack-years. Among women, current smoking was also associated with a thinned echolucent layer that resulted in a non-significant overall association of current smoking with IMT for women. Conclusion Cigarette smoking is associated with carotid artery morphological changes and the association is sex-dependent. The atherogenic effect of smoking appears to be partly reversible among former smokers. IMT measurement alone may not be adequate to detect carotid atherosclerosis associated with cigarette smoking among middle-age women.

  3. Increased intima-media thickness after early-onset preeclampsia

    NARCIS (Netherlands)

    Blaauw, Judith; van Pampus, Maria G; Van Doormaal, Jasper J; Fokkema, M Rebecca; Fidler, Vaclav; Smit, Andries J; Aarnoudse, Jan G

    2006-01-01

    OBJECTIVE: Preeclampsia is associated with cardiovascular atherosclerotic events later in life. However, little is known about earlier subdinical signs of atherosclerosis. We aimed to investigate whether women who recently had preeclampsia show increased intima-media thickness (IMT), as marker of ea

  4. The Correlation Analysis between Hemorheology and Carotid Intima-media Thickness in Type 2 Diabetes Mellitus%2型糖尿病患者颈动脉内膜-中层厚度与血液流变学指标的相关性分析

    Institute of Scientific and Technical Information of China (English)

    徐园园; 纪易斐; 卢学超; 魏迎凤; 翟林云

    2013-01-01

    Objective: To explore the relationship between hemorheology and carotid intima-media thickness (CIMT) in patients with type 2 diabetes (T2DM). Method: Eighty eight patients with T2DM were enrolled in this study. According to the results of CIMT, they were divided into two groups: non-macroangiopathy group and combined with macroangiopathy group, the levels of the index of hemorheology in two groups were detected and compared,and the relationship of CIMT and the index of hemorheology was also analyzed. Results: There was significant difference of CIMT, whole blood viscosity(low shear,middle shear,high shear),plasma viscosity, hematocrit and fibrinogen in two groups (P < 0. 05). And whole blood viscosity (middle shear, low shear), plasma viscosity, hematocrit, fibrinogen were positively relative with CIMT(P<0. 01). Conclusion: The patients with T2DM combined with macroangiopathy have obvious changes of hemorheology, it means abnormal hemorheology may play a role in the formation and development of macroangiopathy.%目的:探讨2型糖尿病患者颈动脉内膜-中层厚度(CIMT)与血液流变学指标的相关性.方法:选取88例糖尿病患者,检查CIMT后,分为血管病变组及无血管病变组,检测两组患者全血粘度、血浆粘度和红细胞压积、纤维蛋白原,对结果进行组间比较及CIMT与血流变指标的相关性分析.结果:血管病变组的CIMT、全血(低切、中切、高切)粘度、血浆粘度、红细胞压积、纤维蛋白原与无血管病变组比较差异有统计学意义(P<0.05);血管病变组CIMT与全血(中切、低切)粘度、血浆粘度、红细胞压积、纤维蛋白原呈显著正相关(P<0.01).结论:糖尿病合并颈动脉血管病变患者常伴有血液流变学指标升高,血液流变学异常变化可能参与颈动脉血管病变的发生发展.

  5. Agenesis of internal carotid artery associated with congenital anterior hypopituitarism

    Energy Technology Data Exchange (ETDEWEB)

    Moon, W.-J. [Department of Diagnostic Radiology, Samsung Medical Center, Seoul (Korea); Institute of Neuroradiology, University of Frankfurt (Germany); Porto, L.; Lanfermann, H.; Zanella, F.E. [Institute of Neuroradiology, University of Frankfurt (Germany); Weis, R. [Department of Pediatric Neurology, University of Frankfurt (Germany)

    2002-02-01

    We report a rare case of unilateral agenesis of the internal carotid artery in association with congenital anterior hypopituitarism. The collateral circulation is supplied by a transsellar intercavernous anastomotic vessel connecting the internal carotid arteries. These abnormalities are well depicted on MRI and MRA. The agenesis of the internal carotid artery may explain the pathogenesis of some of congenital anterior hypopituitarism. (orig.)

  6. Hypertrophy of IMC of carotid artery in Parkinson's disease is associated with L-DOPA, homocysteine, and MTHFR genotype.

    Science.gov (United States)

    Nakaso, Kazuhiro; Yasui, Kenichi; Kowa, Hisanori; Kusumi, Masayoshi; Ueda, Keigo; Yoshimoto, Yuko; Takeshima, Takao; Sasaki, Kiyohiro; Nakashima, Kenji

    2003-03-15

    In recent years, an intense interest has developed in the association between Parkinson's disease (PD) and hyperhomocysteinemia. Homocysteine (Hcy) is a neuronal excitotoxic amino acid, and is well known as a risk factor for vascular diseases. Some reports suggest that the administration of L-DOPA may promote hyperhomocysteinemia and idiopathic atherosclerosis. In this study, we report that a mild hypertrophy of the intima-media complex (IMC) of the carotid artery, which has been established as a marker for systemic atherosclerosis, is observed in PD patients compared with normal subjects. PD patients that were treated with L-DOPA for long durations showed a hypertrophic IMC, while the patients that were not treated with L-DOPA did not show any hypertrophic changes in the IMC. These hypertrophic changes were observed primarily in patients with a Hoehn-Yahr stage of 3-5. PD patients with hypertrophic IMC of the carotid artery also exhibited elevated plasma levels of Hcy associated with the C677T genotype of 5,10-methylenetetrahydrofolate reductase (MTHFR). Moreover, a prolonged duration of treatment with L-DOPA in patients with MTHFR T/T genotype enhanced the hypertrophy of IMC, compared with patients with the C/C or C/T genotype. These results suggest that hyperhomocysteinemia promoted by the C677T genotype of MTHFR and prolonged treatment with L-DOPA enhances atherosclerosis in PD patients and affects their general condition.

  7. Acute internal carotid artery occlusion after carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    Masatoshi Yunoki

    2016-09-01

    Full Text Available We report two cases of acute carotid artery (CA occlusion following carotid endarterectomy (CEA. Case 1: a 58-year-old man was admitted with transient right-sided hemiparesis. Magnetic resonance imaging (MRI and MR angiography (MRA revealed cerebral infarction in the left cerebral hemisphere and left CA stenosis. Ten days after admission, he underwent CEA. 24 h after surgery, he developed right hemiplegia. MRI and MRA demonstrated a slightly enlarged infarction and left internal carotid artery (ICA occlusion. Emergency reoperation was performed and complete recanalization achieved. The patient made a clinically significant recovery. Case 2: a 65 year-old man underwent a right-sided CEA for an asymptomatic 80% CA stenosis. 48 h after surgery, his family noticed he was slightly disorientated. MRI and MRA revealed multiple infarctions and right ICA occlusion. He was treated with antiplatelet therapy without reoperation because sufficient cross-flow from the left ICA through the anterior communicating artery was demonstrated by angiography, and his neurological symptoms were mild. His symptoms gradually alleviated and he was discharged 14 days after surgery. With ICA occlusion after CEA, immediate re-operation is mandatory with severe neurological symptoms, whereas individualized judgement is needed when the symptoms are mild.

  8. Oxygen transfer in human carotid artery bifurcation

    Institute of Scientific and Technical Information of China (English)

    Z.G.Zhang; Y.B.Fan; X.Y.Deng

    2007-01-01

    Arterial bifurcations are places where blood flow may be disturbed and slow recirculation flow may occur.To reveal the correlation between local oxygen transfer and atherogenesis, a finite element method was employed to simulate the blood flow and the oxygen transfer in the human carotid artery bifurcation. Under steady-state flow conditions, the numerical simulation demonstrated a variation in local oxygen transfer at the bifurcation, showing that the convective condition in the disturbed flow region may produce uneven local oxygen transfer at the blood/wall interface.The disturbed blood flow with formation of slow eddies in the carotid sinus resulted in a depression in oxygen supply to the arterial wall at the entry of the sinus, which in turn may lead to an atherogenic response of the arterial wall, and contribute to the development of atherosclerotic stenosis there.

  9. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  10. Changes of carotid intima-media thickness in type 2 diabetic patients with obstructive sleep apnea-hypopnea syndrome%2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征患者颈动脉内膜中层厚度变化

    Institute of Scientific and Technical Information of China (English)

    蒋晓真; 奚峰; 陈蕊华; 邹宇峰; 顾哲; 周斌

    2016-01-01

    Objective To investigate the difference of carotid intima-media thickness (IMT) between type 2 diabetic patients with or without obstructive sleep apnea-hypopnea syndrome (OSAHS),and the correlations between IMT and severity of OSAHS.Methods Seventy five inpatients with type 2 diabetes were consecutively enrolled from September to December,2013.Height,weight,waist circumference,hip circumference,blood pressure,blood glucose,blood lipids and fasting insulin were measured.Moreover,all patients undertook the carotid ultrasonography and polysomnography test (PSG),and were divided into two groups:42 patients with OSAHS (OD group),and 33 patients without OSAHS (DM group),according to the results of PSG.The differences of parameters between two groups were compared,and the correlations between IMT and other clinical characteristics were assessed.Results Body weight,waist circumference,fasting insulin(FINS),homeostasis model of assessment for insulin resistence index (HOMA-IR),carotid IMT,carotid resistance index (C-RI),Epworth sleepiness scale (ESS),oxygen reduction index (ODI),and apnea/hypopnea index (AHI) were higher (t =1.87-8.43,all P < 0.05),while lowest oxygen saturation (LSaO2,t =7.38,P < 0.05) was lower in OD group compared with those in DM group.Univariate analysis showed that carotid IMT was positively associated with AHI,body weight,body mass index,waist circumference,lgFINS,lgHOMA-IR,C-RI,and ODI (r =0.24-0.70,all P < 0.05),and negatively correlated with LSaO2 (r =-0.44,P < 0.01).Results of multiple regression analysis indicated that C-RI (β =0.35,P < 0.01),AHI (β =0.28,P =0.01) and lgFINS (β =0.21,P =0.04) were independent predictors of carotid IMT,after adjusting for sex and age.Conclusions Carotid IMT is increased in patients with both type 2 diabetes and OSAHS compared with patients with diabetes alone.The severity of OSAHS is associated with the increase of carotid IMT.%目的 探讨2型糖尿病合并阻塞性睡眠呼吸暂停低通

  11. Haemodynamic evaluation of carotid artery disease

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T

    1989-01-01

    evaluating therapeutic modalities or natural history of carotid artery disease should therefore include a test capable of assessing cerebral haemodynamics. However, most studies, invasive as well as non-invasive, have focused on the ability of the test to diagnose the ICA lesions itself, rather than...

  12. Management of Extracranial Carotid Artery Aneurysm

    NARCIS (Netherlands)

    Welleweerd, J. C.; den Ruijter, H. M.; Nelissen, B. G. L.; Bots, M. L.; Kappelle, L. J.; Rinkel, G. J. E.; Moll, F. L.; de Borst, G. J.

    2015-01-01

    Introduction: Aneurysms of the extracranial carotid artery (ECAA) are rare. Several treatments have been developed over the last 20 years, yet the preferred method to treat ECAA remains unknown. This paper is a review of all available literature on the risk of complications and long-term outcome aft

  13. CARDIAC TRANSPLANT REJECTION AND NON-INVASIVE COMON CAROTID ARTERY WALL FUNCTIONAL INDICES

    Directory of Open Access Journals (Sweden)

    A. O. Shevchenko

    2015-01-01

    Full Text Available Allograft rejection would entail an increase in certain blood biomarkers and active substances derived from activated inflammatory cells which could influence entire vascular endothelial function and deteriorate arterial wall stiffness. We propose that carotid wall functional indices measured with non-invasive ultrasound could we valuable markers of the subclinical cardiac allograft rejection. Aim. Our goal was to analyze the clinical utility of functional common carotid wall (CCW variables measured with high-resolution Doppler ultrasound as a non-invasive screening tool for allograft rejection in cardiac transplant patients (pts. Methods. One hundred and seventy one pts included 93 cardiac recipients, 30 dilated cardiomyopathy waiting list pts, and 48 stable coronary artery disease (SCAD pts without decompensated heart failure were included. Along with resistive index (Ri, pulsative index (Pi, and CCW intima-media thickness (IMT, CCW rigidity index (iRIG was estimated using empirical equation. Non-invasive evaluation was performed in cardiac transplant recipients prior the endomyo- cardial biopsy. Results. Neither of Ri, Pi, or CCW IMT were different in studied subgroups. iRIG was signifi- cantly lower in SCAD pts when compared to the dilated cardiomyopathy subgroup. The later had similar values with cardiac transplant recipients without rejection. Antibody-mediated and cellular rejection were found in 22 (23.7% and 17 (18.3% cardiac recipients, respectively. Mean iRIG in pts without rejection was significantly lower in comparison to antibody-mediated rejection and cell-mediated (5514.7 ± 2404.0 vs 11856.1 ± 6643.5 and 16071.9 ± 10029.1 cm/sec2, respectively, p = 0.001. Area under ROC for iRIG was 0.90 ± 0.03 units2. Analysis showed that iRIG values above estimated treshold 7172 cm/sec2 suggested relative risk of any type of rejection 17.7 (95%CI = 6.3–49.9 sensitivity 80.5%, specificity – 81.1%, negative predictive value – 84

  14. Carotid artery grafting for restenosis after carotid endarterectomy.

    Science.gov (United States)

    Pokrovskiĭ, A V; Kuntsevich, G I; Beloiartsev, D F; Burtseva, E A; Fedorov, E E

    2007-01-01

    The paper analyzes outcomes of 12 internal carotid artery (ICA) graftings for repeat stenosis after carotid endarterectomy (CEA) in 11 patients. In 6 cases restenosis occurred after eversion CEA, in 5 - after conventional patch CEA, and in 1 case - after ICA patch angioplasty for post-CEA restenosis. Critical restenosis >75% in reconstruction area was an indication for surgical intervention. There was 1 case of graft thrombosis in early postoperative period with hemispherical stroke and lethal outcome. Eight patients were examined in late postoperative period. Mean follow-up was 34?+/-?8.44 months (from 16 to 48 months). No cerebrovascular disturbances in operated ICA feeding area were detected. In 6 patients graft patency was good, while 2 smoking patients with diabetes mellitus and hyperlipidemia demonstrated repeat restenosis of proximal anastomosis >70%.

  15. Severe orthostatic hypotension due to unilateral carotid artery dissection

    Directory of Open Access Journals (Sweden)

    Nobuyuki Ishii

    2014-06-01

    Full Text Available A 46-year-old woman was admitted to our hospital with mild right-sided hemiparesis and orthostatic hypotension. Magnetic resonance angiography of the neck showed stenosis of the left distal carotid sinus surrounded by intraluminal hyperintensities on both T1-weighted and T2-weighted images, representing a periluminal hematoma secondary to carotid artery dissection. The dissection hyperextended the carotid artery wall and stimulated baroreceptors in the carotid sinus. The stimulated baroreceptors induced carotid sinus hypersensitivity, which may have been related to her orthostatic hypotension. Post-stroke orthostatic hypotension should prompt consideration of carotid artery dissection.

  16. Percutaneous cervical carotid artery access with stenting of the left internal carotid artery in an elderly patient

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient's refusal for surgery, direct carotid access was his only option.

  17. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    Directory of Open Access Journals (Sweden)

    Su T

    2011-08-01

    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  18. Stenosis of calcified carotid artery detected on Panoramic Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, So Yang; Oh, Won Mann; Yoon, Suk Ja; Yoon, Woong; Lee, Jae Seo; Kang, Byung Cheol [School of Dentistry, Chonnam National University, Seoul (Korea, Republic of); Palomo, Juan M. [Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland (United States)

    2009-09-15

    This study aimed to investigate the luminal stenosis of the internal carotid artery with calcification detected on panoramic radiographs. This study used fifty carotid arteries of 36 dental patients whose panoramic radiograph and computed tomography angiography (CTA) revealed the presence of carotid artery calcification. A neuroradiologist interpreted CTA to determine the degree of stenosis of the internal carotid arteries. The degree of stenosis was stratified in four stages; normal (no stenosis), mild stenosis (1-49%), moderate stenosis (50-69%) and severe stenosis (70-99%). Among the fifty carotid arteries with calcification detected on both panoramic radiography and CTA, 20 carotid arteries (40%) were normal, 29 carotid arteries (18%) had mild stenosis, 1 carotid artery (2%) had moderate stenosis, and there was none with severe stenosis. Sixty percent of the carotid arteries with calcification detected on both panoramic radiography and CTA had internal luminal stenosis, and two percent had moderate stenosis. When carotid atheroma is detected on panoramic radiograph, it is possible that the dental patient has luminal stenosis of the internal carotid artery.

  19. Quantitative evaluation of the structure and function of the common carotid artery in hypertriglyceridemic subjects using ultrasound radiofrequency-data technology

    Energy Technology Data Exchange (ETDEWEB)

    Dan, Hai-Jun, E-mail: danhaijun@163.com [Department of Physical Examination, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei (China); Wang, Yan [Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai 200233 (China); Sha, Hai-Jing [Second Department of Geriatrics, The Central Hospital of Handan, Handan 056001, Hebei (China); Wen, Shu-Bin [Department of Physical Examination, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei (China)

    2012-11-15

    Assessment of the properties of blood-vessel walls by ultrasound radiofrequency (RF)-data technology is an innovative technique. We quantitatively evaluated the intima-media thickness (IMT) and arterial elasticity of the common carotid artery (CCA) in asymptomatic subjects with hypertriglyceridemia (HTG) using RF-data technology. Thirty HTG subjects and 30 matched controls were enrolled in the study. The common carotid arterial systolic diameter, diastolic diameter, IMT, carotid distensibility (CD), local pulse wave velocity (PWV{beta}), and stiffness ({beta}) were compared between the two groups, as was the correlation between triglyceride level and the parameters mentioned above. The HTG group had significantly higher values of CCA-IMT compared with the control group (p < 0.001). There were significant differences between the HTG group and controls in terms of higher values of PWV{beta} and {beta}, and lower values of CD (all p < 0.05). No difference was observed in terms of the systolic and diastolic diameter of the CCA (p > 0.05). The level of triglycerides had significant positive correlations with CCA-IMT (r = 0.493, p < 0.001), whereas significant correlations with CD, PWV{beta}, and {beta} were not observed in the HTG group. Ultrasound RF-data technology can be used to non-invasively and quantitatively detect the change in the structure and function of the CCA in asymptomatic HTG subjects for evaluating preclinical atherosclerosis.

  20. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial.

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2010-03-20

    Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy.

  1. A Data Mining Approach for Cardiovascular Disease Diagnosis Using Heart Rate Variability and Images of Carotid Arteries

    Directory of Open Access Journals (Sweden)

    Hyeongsoo Kim

    2016-06-01

    Full Text Available In this paper, we proposed not only an extraction methodology of multiple feature vectors from ultrasound images for carotid arteries (CAs and heart rate variability (HRV of electrocardiogram signal, but also a suitable and reliable prediction model useful in the diagnosis of cardiovascular disease (CVD. For inventing the multiple feature vectors, we extract a candidate feature vector through image processing and measurement of the thickness of carotid intima-media (IMT. As a complementary way, the linear and/or nonlinear feature vectors are also extracted from HRV, a main index for cardiac disorder. The significance of the multiple feature vectors is tested with several machine learning methods, namely Neural Networks, Support Vector Machine (SVM, Classification based on Multiple Association Rule (CMAR, Decision tree induction and Bayesian classifier. As a result, multiple feature vectors extracted from both CAs and HRV (CA+HRV showed higher accuracy than the separative feature vectors of CAs and HRV. Furthermore, the SVM and CMAR showed about 89.51% and 89.46%, respectively, in terms of diagnosing accuracy rate after evaluating the diagnosis or prediction methods using the finally chosen multiple feature vectors. Therefore, the multiple feature vectors devised in this paper can be effective diagnostic indicators of CVD. In addition, the feature vector analysis and prediction techniques are expected to be helpful tools in the decisions of cardiologists.

  2. 中老年人糖化血红蛋白水平与颈动脉内膜-中层厚度的相关性研究:广州生物库心血管疾病亚队列%Effects of plasma levels of glycosylated hemoglobin A1c on carotid intima media thickness in the elderly Chinese people:the cardiovascular disease subgroup of Guangzhou Biobank Cohort Study

    Institute of Scientific and Technical Information of China (English)

    林洁明; 林大庆; 江朝强; 徐琳; 刘斌; 岳晓军; 靳雅丽; Thomas GN

    2010-01-01

    Objective To investigate the effect of glycosylated hemoglobin A1c(HbA1c) on carotid atheresclerosis in relatively healthy elderly Chinese people.Methods A total of 1863 relatively healthy Chinese people(≥50 years old)were randomized enrolled from the Guangzhou Biobank Cohort Study(GBCS).Personal general historiy Was collected before the study in all object.The blood pressure,fasting glucose,lipids,HbA1c and common carotid artery intima-median thickness(CCA-IMT)were measured respectively.After adjustment relevant confounding factors,analysis of convariance was used for continuous variable analysis.Results (1)Ater adjusting for age,sex and fasting glucose,mean CCA-IMT were increased significantly with the increase of HbA1c level in all participant(P=0.005).The results of linear regression models show that, HbA1c levels was positively associated with mean CCA-IMT after adjusting for age,sex,smoking,physical activity,waist circumference,systolic and diastolic blood pressure,triglyceride,hish-density,low-density lipoprotein cholesterol and fasting glucose(regression coefficient t=0.014,P=0.03).Compared to the optimal group(HbA1c7.5%)were 1.62(1.10,2.38)and 1.76(0.86,3.63)respectively(P for trend=0.01).Conclusions Increasing HbA1c level is an independent risk factor for carotid athemsclerosis;that HbA1c-lowering treatment may be an important means for preventing the progression of carotid atherosclerosis.%目的 探讨相对健康的中老年人血中糖化血红蛋白(HbAlc)含量对颈动脉硬化的影响.方法 从广州生物库队列中单纯随机抽样收集1863名年龄≥50岁的广州市居民的个人资料,问卷调查其病史、体格检查及测定血清空腹血糖、血脂、HbA1c的含量并应用彩色多普勒超声测量颈总动脉内膜-中层厚度(intima media thickness,IMT).在调整相关混染因素后,应用协方差分析进行连续变量分析.结果 (1)在调整年龄、性别和空腹血糖等因素后,平均颈总动脉IMT随HbA1c

  3. Automated carotid artery intima layer regional segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Meiburger, Kristen M; Molinari, Filippo [Biolab, Department of Electronics, Politecnico di Torino, Torino (Italy); Acharya, U Rajendra [Department of ECE, Ngee Ann Polytechnic (Singapore); Saba, Luca [Department of Radiology, A.O.U. di Cagliari, Cagliari (Italy); Rodrigues, Paulo [Department of Computer Science, Centro Universitario da FEI, Sao Paulo (Brazil); Liboni, William [Neurology Division, Gradenigo Hospital, Torino (Italy); Nicolaides, Andrew [Vascular Screening and Diagnostic Centre, London (United Kingdom); Suri, Jasjit S, E-mail: filippo.molinari@polito.it [Fellow AIMBE, CTO, Global Biomedical Technologies Inc., CA (United States)

    2011-07-07

    Evaluation of the carotid artery wall is essential for the assessment of a patient's cardiovascular risk or for the diagnosis of cardiovascular pathologies. This paper presents a new, completely user-independent algorithm called carotid artery intima layer regional segmentation (CAILRS, a class of AtheroEdge(TM) systems), which automatically segments the intima layer of the far wall of the carotid ultrasound artery based on mean shift classification applied to the far wall. Further, the system extracts the lumen-intima and media-adventitia borders in the far wall of the carotid artery. Our new system is characterized and validated by comparing CAILRS borders with the manual tracings carried out by experts. The new technique is also benchmarked with a semi-automatic technique based on a first-order absolute moment edge operator (FOAM) and compared to our previous edge-based automated methods such as CALEX (Molinari et al 2010 J. Ultrasound Med. 29 399-418, 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CULEX (Delsanto et al 2007 IEEE Trans. Instrum. Meas. 56 1265-74, Molinari et al 2010 IEEE Trans. Ultrason. Ferroelectr. Freq. Control 57 1112-24), CALSFOAM (Molinari et al Int. Angiol. (at press)), and CAUDLES-EF (Molinari et al J. Digit. Imaging (at press)). Our multi-institutional database consisted of 300 longitudinal B-mode carotid images. In comparison to semi-automated FOAM, CAILRS showed the IMT bias of -0.035 {+-} 0.186 mm while FOAM showed -0.016 {+-} 0.258 mm. Our IMT was slightly underestimated with respect to the ground truth IMT, but showed uniform behavior over the entire database. CAILRS outperformed all the four previous automated methods. The system's figure of merit was 95.6%, which was lower than that of the semi-automated method (98%), but higher than that of the other automated techniques.

  4. Impact of family history on relations between insulin resistance, LDL cholesterol and carotid IMT in healthy adults.

    LENUS (Irish Health Repository)

    Anderwald, Christian

    2010-08-01

    Insulin resistance (IR) is implicated as an independent risk factor for vascular disease. The aim of this study was to assess the impact of family history (FH) of type 2 diabetes (T2DM) and\\/or cardiovascular disease (CVD) on the associations between IR, low-density-lipoprotein cholesterol (LDL-C) and subclinical atherosclerosis (common and internal carotid artery intima media thickness (IMT)) in healthy European adults.

  5. Carotid Artery Stenting 2013: Thumbs up

    Science.gov (United States)

    Wagdi, Philipp

    2013-01-01

    It has been customary for interventional cardiologists involved in carotid artery stenting, to underline non-inferiority of the percutaneous technique versus surgical carotid endarterectomy. To that end, all cause morbidity and mortality figures of both methods are compared. Surgery has, in most large randomized studies, had an edge over stenting in terms of cerebrovascular adverse events. This may have partly been due to occasional indiscriminate indication for stenting in lesions and/or vessels with unfavourable characteristics (severe target vessel tortuosity and calcification, Type III aortic arch, and so on). On one hand, the author pleads for improvement of the excellent results of endarterectomy, by subjecting all patients planned for surgery to a thorough preoperative cardiological work up, including generous invasive investigation, thus reducing the incidence of perioperative myocardial infarction, heart failure and cardiac death. On the other hand, we are convinced that the results of carotid stenting should then be compared to best practice surgery. The rate of neurological adverse event rate after carotid endarterectomy at our institution lies under 0.7% at 30 days postoperatively. Specifically, the goal should be that carotid stenting underbids surgical endarterectomy, also and mainly, in terms of cerebral and cerebrovascular adverse events. Cardiac morbidity and mortality as well as laryngeal nerve palsy should no more be the main arguments for the percutaneous approach. This should easily be possible if patient selection for carotid revascularisation would be approached according to morphological criteria, in analogy with the “Syntax”-score used to optimise revascularisation strategies in coronary artery disease.

  6. The contribution of vascular smooth muscle, elastin and collagen on the passive mechanics of porcine carotid arteries.

    Science.gov (United States)

    Kochová, P; Kuncová, J; Svíglerová, J; Cimrman, R; Miklíková, M; Liška, V; Tonar, Z

    2012-08-01

    The main components responsible for the mechanical behavior of the arterial wall are collagen, elastin, and smooth muscle cells (SMCs) in the medial layer. We determined the structural and mechanical changes in porcine carotid arteries after administration of Triton® X-100, elastase, and collagenase using the inflation-deflation test. The arteries were intraluminarly pressurized from 0 to 200 mmHg, and the outer diameter of the artery was measured. The pressure-strain elastic modulus was determined based on the pressure/diameter ratio. The intima-media thickness, wall thickness, thickness of the tunica adventitia layer, and the area fractions of SMCs, elastin, and collagen within the arterial wall (A(A)(SMC/elastin/collagen, wall)) were measured using stereological methods. The relative changes in the relevant components of the treated samples were as follows: the decrease in A(A)(SMC, wall) after administration of Triton® X-100 was 11% ± 7%, the decrease in A(A)(elastin, wall) after administration of elastase was 40% ± 22%, and the decrease in A(A)(collagen, wall) after the application of collagenase was 51% ± 22%. The Triton® X-100 treatment led to a decrease in the SMC content that was associated with enlargement of the arterial wall (outer diameter) for pressures up to 120 mmHg, and with mechanical stiffening of the arterial wall at higher pressures. Elastase led to a decrease in the elastin content that was associated with enlargement of the arterial wall, but not with stiffening or softening. Collagenase led to a decrease in collagen content that was associated with a change in the stiffness of the arterial wall, although the exact contribution of mechanical loading and the duration of treatment (enlargement) could not be quantified.

  7. Lesion load in unprotected carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Papanagiotou, P.; Roth, C.; Karp, K.; Krick, C.; Schieber, H.; Mueller, M.; Reith, W. [University of the Saarland, Department for Diagnostic and Interventional Neuroradiology, Homburg (Germany); Fassbender, K.; Haass, A. [University of the Saarland, Division of Neurology, Homburg (Germany)

    2009-05-15

    The purpose of the study was to determine the incidence of new ischemic lesions found on diffusion-weighted MR imaging (DWI) in nonselected patients after unprotected carotid artery stent placement. We retrospectively reviewed a nonrandomized cohort of 197 patients presenting with carotid occlusive disease who underwent unprotected carotid artery stent placement between 2003 and 2006. Mean degree of stenosis was 86.94% {+-} 9.72. In all patients, DWI was obtained before and 24 h after stent placement. New lesions were evaluated according to size and location. In 59 of 197 patients (29.9%), new ischemic lesions were found on DWI in the vessel dependent area. In 23 of 197 patients (11.7%), new ischemic lesions were found in the vessel independent area. Combined stroke/death rate was 3.63%. In our series of unprotected carotid angioplasty with stent, we found new DWI lesions in 34% of the patients. Further studies should now show in how far protection devices can reduce these lesions. (orig.)

  8. Relationship between carotid intima-media thickness and glomerular filtration rate in type 2 diabetic patients%2型糖尿病患者颈动脉内中膜厚度与肾小球滤过率的相关性分析

    Institute of Scientific and Technical Information of China (English)

    贾艳坤; 韩丽萍; 谢云

    2012-01-01

    Objective To investigate the correlation between carotid intima-media thickness (cIMT) and glomerular filtration rate (GFR) in type 2 diabetic patients. Methods 143 patients whose age is above 45 years were selected and the patients' blood pressure should be controlled below 140/90 mmHg. The patients were divided into two groups: the normal group (cIMT<0. 9 mm) and the thick group (cIMT≥0. 9 mm) by the cut level of cIMT 0. 9 mm. The age. Duration. MAU frequency, GFR and biochemical indexes were compared between them. Results cIMT thick group's age, duration and MAU frequency were much higher than those of cIMT normal group, and the GFR of the thick group was much lower than that of the normal group (P<0. 05). No statistical difference was found in biochemical indexes such as fasting glucose and lipids between two groups. Multiple stepwise regression analysis showed cIMT had a positive correlation with age, duration, and had a negative correlation with eGFR Conclusions With the development of the atherosclerosis, GFR gradually decreases and contributes to the occurance and development of early-stage atherosclerosis.%目的 探讨T2DM患者颈动脉内中膜厚度(cIMT)与肾小球滤过率(GFR)的相关性.方法 随机选取年龄>45岁的血压控制在140/90 mmHg以下的T2DM患者143例,以cIMT 0.9mm为标准将其分为cIMT<0.9 mm(IMT正常组)和cIMT≥0.9mm( IMT增厚组),比较两组间年龄、病程、早期肾病( MAU)所占比例、GFR及各项生化指标的差异. 结果 IMT增厚组的年龄、糖尿病病程、MAU所占比例明显高于IMT正常组,而GFR则明显低于IMT正常组(P<0.05).多元逐步回归分析显示cIMT与年龄、糖尿病病程呈正相关,而与GFR呈负相关. 结论 随着动脉硬化的不断进展,GFR呈不断下降趋势且独立于传统的心血管危险因素参与早期动脉硬化的发生与发展.

  9. Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Daniela Fodor

    Full Text Available CONTEXT AND OBJECTIVES: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT of the common carotid artery (CCA, presence of calcified atherosclerotic plaques and bone mineral density (BMD evaluated by dual energy X-ray absorptiometry (DXA, in postmenopausal women. DESIGN AND SETTING: Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS: We studied the IMT (left and right CCA and mean IMT and T-score (lumbar spine L2-L4, femoral neck and total hip in 100 postmenopausal women (mean age 64.5 years. The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS: IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05. IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001, high blood pressure (P = 0.005 and osteoporotic vertebral fractures (P = 0.048 showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS: In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.

  10. Cocoa intake and arterial stiffness in subjects with cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Recio-Rodríguez José

    2012-02-01

    Full Text Available Abstract Background To analyze the relationship of cocoa intake to central and peripheral blood pressure, arterial stiffness, and carotid intima-media thickness in subjects with some cardiovascular risk factor. Findings Design: A cross-sectional study of 351 subjects (mean age 54.76 years, 62.4% males. Measurements: Intake of cocoa and other foods using a food frequency questionnaire, central and peripheral (ambulatory and office blood pressure, central and peripheral augmentation index, pulse wave velocity, ambulatory arterial stiffness index, carotid intima-media thickness, and ankle-brachial index. Results: Higher pulse wave velocity and greater cardiovascular risk were found in non-cocoa consumers as compared to high consumers (p Conclusions In subjects with some cardiovascular risk factors, cocoa consumption does not imply improvement in the arterial stiffness values. Trial Registration Clinical Trials.gov Identifier: NCT01325064.

  11. Estimation of Stiffness Parameter on the Common Carotid Artery

    Science.gov (United States)

    Koya, Yoshiharu; Mizoshiri, Isao; Matsui, Kiyoaki; Nakamura, Takashi

    The arteriosclerosis is on the increase with an aging or change of our living environment. For that reason, diagnosis of the common carotid artery using echocardiogram is doing to take precautions carebropathy. Up to the present, several methods to measure stiffness parameter of the carotid artery have been proposed. However, they have analyzed at the only one point of common carotid artery. In this paper, we propose the method of analysis extended over a wide area of common carotid artery. In order to measure stiffness parameter of common carotid artery from echocardiogram, it is required to detect two border curves which are boundaries between vessel wall and blood. The method is composed of two steps. The first step is the detection of border curves, and the second step is the calculation of stiffness parameter using diameter of common carotid artery. Experimental results show the validity of the proposed method.

  12. [Prevalence of carotid atherosclerosis in a cohort of Mexico City].

    Science.gov (United States)

    Rodríguez Saldaña, J; Cantú Brito, C; Sosa Espinosa, P; Reynoso Marenco, M T; Zuckermann Foullón, D; Barinagarrementería Aldatz, F

    1998-01-01

    In order to investigate the prevalence of atherosclerosis in Mexico, high resolution ultrasound and color Doppler flow imaging of carotid arteries were carried out in a group of participants in CUPA project, a cohort study started in 1989 among persons 60 years and older living permanently in a high rise in México City. Imaging studies included identification of 4 atherosclerosis related abnormalities: 1) intima media thickness; 2) kinkings and tortuousness; 3) non-stenosing plaques; and 4) significant carotid stenosis (> 50%). Analysis of 198 Doppler ultrasonographic studies in 56 males and 142 females showed an overall prevalence of atherosclerosis related lesions of 65.6%, with increasing frequency by age groups: 33% in younger than 65 year-old, 71% in 65-74 years, and up to 88% in the 75 years and older group. The prevalence of high grade stenosis was low (6%) whereas the overall frequency of non-stenosing plaques and intima-media thickness was higher than 60%. Intima-media thickness was more common in males while non-stenosing plaques and high grade stenosis were more frequent in females. However, there were not significant differences among women and men when atherosclerotic lesions were analyzed by age groups. This is the first report on the prevalence of atherosclerosis in a Mexican population using ultrasonography. Findings of the investigation document the high prevalence of atherosclerosis among elderly resident in Mexico City.

  13. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  14. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  15. The Dolichoarteriopathia of Common Carotid Artery Narrowing the Airway

    Directory of Open Access Journals (Sweden)

    Erkan Eski

    2013-01-01

    Full Text Available Tortuousity of the common carotid artery is rarely seen in otorinolaryngologic  practice. In this report, a case of tortuous common carotid artery narrowing the airway and indenting the epiglottis is presented. In endoscopic examination, pulsating bulge at the level of right lateral farengeal wall, pyriform sinus and larynx was found in a 73 year-old female. Computerized tomographic scan showed tortuous  right common carotid artery bulging the submucosal area of the oropharynx and pyriform sinus. Awareness of the tortuous common carotid artery before any  laryngologic surgical intervention is very important to prevent serious complications.

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  4. Cardiovascular risk factor profiles for peripheral artery disease and carotid atherosclerosis among Chinese older people: a population-based study.

    Directory of Open Access Journals (Sweden)

    Yajun Liang

    Full Text Available OBJECTIVES: Epidemiological data concerning atherosclerotic disease among older people in rural China are sparse. We seek to determine prevalence and cardiovascular risk factor profiles for peripheral artery disease (PAD and carotid atherosclerosis (CAS among Chinese older people living in a rural community. METHODS: This cross-sectional study included 1499 participants (age ≥60 years, 59.0% women of the Confucius Hometown Aging Project in Shandong, China. From June 2010-July 2011, data were collected through interviews, clinical examinations, and laboratory tests. PAD was defined as an ankle-brachial index ≤0.9. Carotid intima-media thickness (cIMT and carotid artery stenosis were assessed by ultrasonography. We defined moderate stenosis as carotid stenosis ≥50%, and severe stenosis as carotid stenosis ≥70%. cIMT≥1.81 mm was considered as an increased cIMT (a measure of CAS. Data were analyzed with multiple logistic models. RESULTS: The prevalence was 5.7% for PAD, 8.9% for moderate stenosis, 1.8% for severe stenosis, and 11.2% for increased cIMT. After controlling for multiple potential confounders, diabetes, an increased low-density lipoprotein cholesterol (LDL-C/high-density lipoprotein cholesterol (HDL-C ratio, and hypertension were significantly or marginally associated with PAD. Ever smoking, hypertension, and an increased LDL-C/HDL-C ratio were significantly associated with an increased likelihood of increased cIMT. An increasing number of those cardiovascular risk factors were significantly associated with an increasing odds ratio of PAD and increased cIMT, respectively (p for linear trend <0.001. CONCLUSION: Among Chinese older people living in a rural community, PAD, carotid artery stenosis, and an increased cIMT are relatively uncommon. Cardiovascular risk factor profiles for PAD and CAS are slightly different, with hypertension and an increased LDL-C/HDL-C ratio being associated with an increased likelihood of both PAD and

  5. Cerebellar arteries originating from the internal carotid artery: angiographic evaluation and embryologic explanations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Han, Moon Hee; Yu, In Gyu; Chang, Ki Hyun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Dae Ho [Soonchunhyang Univ. College of Medicine, Asan(Korea, Republic of)

    1997-06-01

    To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

  6. Endarterectomy or carotid artery stenting : the quest continues part two

    NARCIS (Netherlands)

    Kolkert, Joe L.; Meerwaldt, Robbert; Geelkerken, Robert H.; Zeebregts, Clark J.

    2015-01-01

    BACKGROUND: Although randomized trials on carotid artery stenting (CAS) could not establish its equivalence to carotid endarterectomy (CEA) in patients with symptomatic carotid disease, CAS is rapidly evolving. Data on long-term outcome after CAS from randomized trials have now become available and

  7. Circulating lipocalin-2 and retinol-binding protein 4 are associated with intima-media thickness and subclinical atherosclerosis in patients with type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Yang Xiao

    Full Text Available BACKGROUND: The lipocalin family proteins, including lipocalin-2 and retinol-binding protein 4 (RBP4, are adipokines closely associated with obesity-related metabolic disorders. In this study, we evaluated the association of serum lipocalin-2 and RBP4 with intima-media thickness (IMT and subclinical atherosclerosis in type 2 diabetic patients. METHODS AND RESULTS: Serum levels of lipocalin-2 and RBP4 were measured in 284 type 2 diabetic patients. Subclinical atherosclerosis was assessed by IMT at carotid, femoral and iliac arteries with ultrasound. Patients with subclinical atherosclerosis showed significantly higher circulating concentrations of lipocalin-2 and RBP4 when compared to those without [112.9 (86.4 to 202.1 µg/L versus 77.2(55.0-150.4 µg/L, 37.1(32.3-40.8 mg/L versus 23.2(20.1-29.2 mg/L, respectively; P = 0.002, P<0.001, respectively]. Moreover, positive correlations were observed between carotid IMT and lipocalin-2 (r = 0.170, P = 0.018 or RBP4 (r = 0.132, P = 0.040, femoral IMT and lipocalin-2 (r = 0.160, P = 0.027, as well as between iliac IMT and RBP4 (r = 0.241, P<0.001. Multiple logistic regression analysis further demonstrated that these two adipokines were independent risk factors for subclinical atherosclerosis in type 2 diabetes. CONCLUSION: Circulating levels of lipocalin-2 and RBP4 are positively correlated with carotid IMT and subclinical atherosclerosis in type 2 diabetes, which suggests a potential role of these two lipid-binding chaperones in the pathogenesis of vascular complications of diabetes.

  8. Review of stents for the carotid artery.

    Science.gov (United States)

    Bosiers, M; Deloose, K; Verbist, J; Peeters, P

    2006-04-01

    The individual characteristics of a stent may make it an attractive choice in some circumstances, but render it a less desirable option in others. The applicability depends primarily on the arterial anatomy and the specific details of the lesion being treated. A careful assessment by the interventionalist is required to select the proper type of stent that is of appropriate size. Certainly, personal preferences and familiarity with a specific device may legitimately influence the decision to choose one stent over another. Finally, stent design can play a role in the selection procedure. Although carotid stents are often functionally equivalent in the clinical setting and have been used successfully to treat a wide variety of lesions, a basic knowledge of stent geometry can contribute to make up your mind in certain carotid cases.

  9. Carotid angioplasty with stenting for chronic internal carotid artery occlusion: technical note

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Nozomu; Tanasawa, Toshihiko; Okada, Takeshi; Endo, Otone; Yamamoto, Naohito [Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Department of Neurosurgery, Aichi (Japan); Miyachi, Shigeru; Hattori, Kenichi [Nagoya University Graduate School of Medicine, Department of Neurosurgery, Nagoya (Japan)

    2006-11-15

    Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods. A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset. Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration. In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed. (orig.)

  10. 中青年男性体脂分布与颈动脉内膜中层厚度的相关研究%The study of relationship between body fat distribution and carotid intima-media thickness in young and middle-aged men

    Institute of Scientific and Technical Information of China (English)

    马春朋; 刘兰祥; 杨蕾; 刘晓丽; 王锐; 尹福在; 陆强

    2013-01-01

    Objective To evaluate the relationship between fat distribution and carotid intima-media thickness (CIMT) in young and middle-aged men.Methods Five hundred and one men aged 20-50 years who took physical examination in the first hospital of qinhuangdao were selected.The abdominal obesity group included 299 cases with waist circumference ≥90 cm,and the normol waist circumference group included 202 cases with waist circumference <90 cm.Height,weight and waist circumference were measured and body mass index was calculated.Fasting insulin (FINS) and fasting plasma glucose (FPG) were detected,and homeostasis model assay insulin resistance index (HOMA-IR) was calculated.Total body fat mass (BF),body muscle mass (BM),truncal fat mass (TrF),upper limb fat mass (UF),limb fat mass (LF) were measured by dual energy X-ray absorptiometry (DEXA).BF%(=BF/W) and TrF/BF were calculated.CIMT was detected with color ultrasound.Results (1) The abdominal obesity group showed increased levels of BF%,TrF/BF,BF,BM,TrF,UF,LF,body mass index,waist circumference,CIMT and HOMA-IR,compared with normol waist circumference group (all P <0.05).(2) In Pearson correlation analysis,CIMT had positive correlation with BF%,TrF/BF,BF,BM,TrF,UF,LF,body mass index and waist circumference (R=0.443,0.481,0.429,0.377,0.472,0.376,0.304,all P <0.05).(3)In Pearson correlation analysis,HOMA-IR had positive correlation with BF%,TrF/BF,BF,BM,TrF,UF,LF,body mass index,waist circumference(R =0.510,0.441,0.576,0.502,0.528,0.526,0.577,0.384,0.639,all P<0.05).HOMA-IR had positive correlation with CIMT (R =0.416,P <0.05).(4)In multiple regression analyses,TrF/BF and body mass index were the independent risk factors of CIMT.Conclusion Fat distribution was closely related with CIMT and insulin resistance in young and middle-aged men.To prevent carotid atherosclerosis and cardiovascular diseases,exercise should be recommended and abdominal obesity should be avoided.%目的 探讨中青年男性体

  11. The Effect of Rosuvastatin Combined with Perindopril on LDL-C/HDL-C and Carotid Intima Media Thickness in Hypertension Patients%瑞舒伐他汀联合培哚普利对高血压患者 LDL-C 与 HDL-C 比值和颈动脉内膜中层厚度的影响

    Institute of Scientific and Technical Information of China (English)

    陆洋; 张跃明; 颜永进

    2014-01-01

    目的:探讨瑞舒伐他汀联合培哚普利对高血压患者低密度脂蛋白胆固醇( LDL-C )/高密度脂蛋白胆固醇( HDL-C)和颈动脉内膜中层厚度( IMT)的影响及二者之间的相关性。方法:入选初诊高血压伴高LDL-C血症患者126例,在给予基础降压治疗基础上随机分为治疗组63例(培哚普利+瑞舒伐他汀治疗)和对照组63例(瑞舒伐他汀治疗)。比较治疗前和治疗3周后血压、LDL-C、HDL-C、LDL-C/HDL-C和IMT变化。结果:治疗后治疗组收缩压、舒张压和平均动脉压均较对照组下降明显(P=0.012,P=0.029,P=0.037)。两组患者治疗前后LDL-C、HDL-C比较均没有统计学差异(P均>0.05)。但治疗组治疗后LDL-C/HDL-C下降较对照组明显(P=0.007),平均IMT和最大IMT均明显小于照组( P=0.001,P<0.001)。治疗前后LDL-C/HDL-C差值与平均IMT差值呈正相关( P<0.001,r=0.742)。结论:瑞舒伐他汀联合培哚普利可以逆转高血压伴高LDL-C血症患者颈动脉内膜斑块,二者联合使用对减少心脑血管疾病的发生有重要意义。%Objective:To investigate the efficacy of rosuvastatin combined with perindopril on LDL-C/HDL-C and carotid intima media thickness ( IMT) in hypertension patients, and the correlation between LDL-C/HDL-C and IMT.Method:A total of 126 high LDL-C patients with newly diagnosed hypertension were randomized to treatment group (n=63) and control group (n=63) after enrolled.On the basis of rou-tine antihypertensive therapy , treatment group received rosuvastatin treatment with the addition of perindopril and control group received rosuvastatin treatment only .Blood pressure , LDL-C, HDL-C, LDL-C/HDL-C and IMT were collected before and after 3 weeks treatment .Result:Systolic blood pressure ( SBP ) , dystolic blood pressure ( DBP ) , and mean blood pressure in treatment group were lower than that in control group af

  12. Mathematical model of carotid artery for stent placement

    Science.gov (United States)

    Rahman, Tengku Husna Tengku Abdul; Din, Ummul Khair Salma; Ahmad, Rokiah @ Rozita

    2016-11-01

    The carotid artery stenting is one of the methods used to reduce the effect of artherosclerosis which caused by the thickening of the artery wall. In most of the studies, the measure of wall elasticity, shear stress and the blood pressure through the blood flow were considered. The aim of this study is to determine the position to place the stent inside the carotid artery. A mathematical model is reconstructed to determine the suitable location of the stent in the carotid artery. Throughout the study, differences in fluid flow between a normal carotid artery wall and stenosed carotid artery wall are investigated. Since the existence of the stenosis provides a resistance in the flow, it is important to identify the right position to place the stent. The stent will be placed in the position where stenosis exists to ease the blood to flow normally. Later after the stent placement, the blood flow normally through the blood vessel.

  13. An internal carotid artery aneurysm presenting with dysarthria.

    Science.gov (United States)

    Davey, P T; Rychlik, I; O'Donnell, M; Baker, R; Rennie, I

    2013-10-01

    A 72-year-old woman presented to her general practitioner with a 4-week history of right neck swelling. Clinical examination elicited a pulsatile mass consistent with a carotid artery aneurysm. Five days later the patient noticed her tongue movements had become awkward with associated dysarthria. Computed tomography confirmed a 4cm internal carotid artery aneurysm arising just distally to the carotid bifurcation. She proceeded to transfemoral diagnostic carotid angiography. Balloon occlusion of the right internal carotid artery origin was performed for a ten-minute period without any neurological deficit. The decision was taken to proceed to surgical ligation of the origin of the internal carotid artery. Her symptoms of dysarthria have resolved.

  14. Pulse Wave Velocity in the Carotid Artery

    DEFF Research Database (Denmark)

    Sørensen, Gertrud Laura; Jensen, Julie Brinck; Udesen, Jesper;

    2008-01-01

    The pulse wave velocity (PWV) in the carotid artery (CA) has been estimated based on ultrasound data collected by the experimental scanner RASMUS at DTU. Data is collected from one test subject using a frame rate (FR) of 4000 Hz. The influence of FRs is also investigated. The PWV is calculated from...... distension wave forms (DWF) estimated using cross-correlation. The obtained velocities give results in the area between 3-4 m/s, and the deviations between estimated PWV from two beats of a pulse are around 10%. The results indicate that the method presented is applicable for detecting the local PWV...

  15. A big floating thrombus in the common carotid artery.

    Science.gov (United States)

    La Spada, Michele; Stilo, Francesco; Barillà, David; Spinelli, Francesco

    2011-11-01

    The management of the free-floating thrombus (FFT) is difficult, and it is unclear whether surgical or medical treatment is superior. The common carotid artery is rarely involved. An 80-year-old woman presented with right hand weakness and syncope. Ultrasound showed the presence of FFT in the left common carotid artery. A carotid endarterectomy with Dacron patch angioplasty was immediately performed without complications. In the presence of symptoms, the interventional management of FFT is advised.

  16. Clinical Study on Effect of Garlicin in Stabilizing the Carotid Artery Atherosclerotic Plaque in Patients with Primary Hypertension and Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    CHENG Wen-li; KE Yuan-nan; SHI Zai-xiang; WANG Ying; CHEN Li; JU Gao; FAN Shu-ying

    2006-01-01

    Objective: To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (CAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD). Methods: Seventynine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally. Results: By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P<0.05). Conclusion; Garlicin could stabilize CAAP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.

  17. Recent concepts in the management of extracranial carotid stenosis: Carotid endarterectomy versus carotid artery stenting

    Directory of Open Access Journals (Sweden)

    Jeyaraj D Pandian

    2011-01-01

    Full Text Available Carotid stenosis is seen in 10% of patients with ischemic stroke, and carotid endarterectomy (CEA and carotid artery stenting (CAS are the two invasive treatments options available. Pooled analysis of the three largest randomized trials of CEA involving more than 3000 symptomatic patients estimated 30-day stroke and death rate at 7.1% after CEA. Some subgroups among the symptomatic patients appeared to have more benefit from CEA. These include patients aged 75 years or more, patients with ulcerated plaques, and patients with recent transient ischemic attacks within 2 weeks of randomization. Selection of asymptomatic patients for carotid revascularization should be guided by an assessment of comorbid conditions, life expectancy, and other individual factors, and should include a thorough discussion of the risks and benefits of the procedure with an understanding of patient preferences. The recent trials comparing CEA with CAS has not established its superiority over CEA. The carotid revascularization endarterectomy versus stenting (CREST study showed that CAS is still associated with a higher periprocedural risk of stroke or death than CEA. In patients over 70 years of age, CEA is clearly superior to CAS. The increased risk of nonfatal myocardial infarction in the CREST group subjected to CEA clearly suggests that patients being considered for CEA or CAS require a careful preliminary cardiac evaluation. CAS can be justified for patients whose medical comorbidities or cervical anatomy make them questionable candidates for CEA. The benefit of revascularization by either method versus modern aggressive medical therapy has not been established for patients with asymptomatic carotid stenosis.

  18. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial

    OpenAIRE

    Ederle, J; Dobson, J.; Featherstone, RL; Bonati, LH; van der Worp, HB; de Borst, GJ; lo, TH; Gaines, P.; Dorman, PJ; Macdonald, S; Lyrer, PA; Hendriks, JM; McCollum, C; Nederkoorn, PJ; Brown, MM

    2010-01-01

    Summary Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were ra...

  19. Preliminary research on relationship between long-term low dose radiation exposure and the carotid intima-media thickness of female residents in high background radiation area in Yangjiang, China%阳江高本底女性居民低剂量辐射照射与颈动脉中内膜厚度关系的初步研究

    Institute of Scientific and Technical Information of China (English)

    苏垠平; 谭光享; 雷淑洁; 邹剑明; 张素芬; 刘建香; 李小亮; 孙全富; 秋葉澄伯

    2016-01-01

    Objective To explore the effect on cardiovascular and cerebrovascular diseases for people due to long-term low dose radiation exposure.Methods Four regions were selected from the high background radiation area (HBRA) in Yangjiang,featuring highest external γ radiation dose rate,and two regions from control area (CA) was chosen at the similar distance from downtown as four regions selected from the high background radiation area.Each of one hundred female residents aged more than 50 years old respectively selected from the HBRA in Yangjiang and in the CA.The carotid intima-media thickness (CIMT) was measured using ultrasonic examination.The peripheral venous was sampled to measure the levels of total cholesterol,triglycerides,high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol.Blood pressure,height and weight were also measured.Personal life and living history were collected through questionnaires.The estimation of personal lifetime accumulated radiation dose was based on γ-ray dose rate from indoor and outdoor and the age-related occupancy factor obtained from the previous studies.Results There were statistically significant differences of accumulated radiation dose and CIMT of residents between Yangjiang HBRA and CA [(161.2 ± 38.6) mSy vs.(43.7±7.3) mSv,L (1.0±0.3) mm/R (1.0±0.2) mm vs.L&R (0.9±0.2) mm].The average age was (65.2 ± 10.4) years old for HBRA and (60.7 ± 8.0) years old for CA,respectively.After adjusting confounding factors,including age,blood pressure,BMI and serum cholesterol,the increased cumulative radiation dose was shown to be a risk factor for thickening left CIMT (β =0.000 7,P <0.05).The left CIMT for different dose groups was 0.9,1.0,0.9 and 1.1 mm for < 50,50-100,100-200,> 200 mSv,respectively.Conclusions Long-term low dose radiation exposure may age the vascular,and increasing the risk of atherosclerosis.%目的 探索长期低剂量电离辐射对人群心

  20. 老年2型糖尿病患者颈动脉病变与血清铜锌的关系%Relationship of Serum Copper and Zinc Levels to Carotid Intima-media Thickness of Elderly Patients with Type 2 Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    海静如

    2012-01-01

    Objective To investigate the relationship between carotid intima-media thickness( IMT )and serum microelements of elderly patients with type 2 diabetes. Methods 180 patients with type 2 diabetes were divided into non-elderly group and elderly group, and 90 healthy people were chosen as control group. Serum levels of copper and zinc were detected by atomic absorption spectroscopy. Blood pressure,body mass index,blood sugar,blood fat and IMT were also detected and compared among different groups. Pearson correlation test was applied in the study. Results Blood pressure in elderly group was significantly higher than non-elderly group and control group( P 0.05 ). Compared to non-elderly group,the serum levels of FPG.HbA1cHOMA-IR,TC,TG and LDL-C were statistically higher, and the serum levels of HDL-C was statistically lower in elderly group( P < 0. 05 ). Compared to control group, serum levels of copper in non-elderly group and elderly group were statistically higher,but serum levels of zinc were statistically lower( P <0. 05 ). Compared to non-elderly group,serum level of copper in elderly group was statistically higher,but serum level of zinc was statistically lower( P < 0. 05 ). Pearson correlation tests showed that serum level of copper was positively correlated with IMT and blood sugar, and serum level of zinc was negatively correlated with IMT and blood sugar both in on-elderly group and elderly group. Conclusion High level of serum copper and low level of serum zinc may play an important role on IMT in elderly patients with diabetes.%目的 探讨老年2型糖尿病患者大血管病变与血清微量元素的关系.方法 随机选择非老年2型糖尿病患者和老年2型糖尿病患者各90例,以90例健康体检者作为对照组.采用原子吸收光谱法测定血铜和血锌水平,超声检测颈动脉内膜中层厚度(IMT),同时检测患者血压、体重指数、血糖、血脂.将血铜和血锌水平与血压、体重指数、血糖、血脂

  1. Congenital bilateral absence of the common carotid artery and internal carotid artery: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    YUE Xuan-ye; XI Gang-ming; ZHANG Ying-chun; ZHOU Shao-hua; YE Fei

    2006-01-01

    Absence of the common carotid artery(CCA) and/or internal carotid artery (ICA) is a kind of rare congenital anomaly. This paper reports one patient with bilateral absence of the CCA and ICA who suffered from cerebral infarction. And the relative literatures of the possible cause and collateral circulation were reviewed.

  2. Medical treatment in carotid artery intervention.

    Science.gov (United States)

    Kolkert, J L; Meerwaldt, R; Lefrandt, J D; Geelkerken, R H; Zeebregts, C J

    2011-12-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical therapy has evolved tremendously. Next to aspirin, antiplatelet regimens acting on a different level in the modulation of platelet aggregation have made their entry. Moreover, statin therapy has been introduced. These changes among others in secondary stroke prevention, along with better understanding in life-style adjustments and perioperative medical management, have led to a decrease in stroke recurrence. Secondary prevention is therefore now the most important pillar of medical therapy. It consists of antiplatelet therapy, statins and blood pressure lowering agents in all patients. Small adjustments are recommended for those patients referred for invasive treatment. Moreover, long-term medical treatment is imperative. In this article, we summarize current evidence in literature regarding medical management in patients with previous stroke or TIA.

  3. Successful treatment of common carotid artery transection

    Institute of Scientific and Technical Information of China (English)

    刘健; 肖颖彬; 钟前进; 郝嘉

    2004-01-01

    @@ A case that a patient presented a life-threatening carotid artery hemorrhage after a work-related accident was reported. This case demonstrates the importance of prompt intervention and surgery assisted by cardiopulmonary bypass(CPB). A 22-year-old man was admitted to our hospital with left carotid hemorrhage and progressive dyspnea eight minutes after being injured at work by infra-flying sheet metal. Upon arrival, he was semi-conscious and anemic,whose blood pressure could not be measured. Clinically,he presented poor peripheral perfusion with pale, cool extremities, and oliguria. Under tight digital compression of the left cervical incision of 2 - 5 cm long, endotracheal intubation was performed and a central venous catheter was placed. The severe arterial bleeding could not be controlled even applying dopamine at dose of 10 - 15 μg· kg- 1 · min- 1and 1 200 ml of blood transfusion and 1 000 ml of Gelofusine. The patient was immediately transferred to the operation room of the cardiovascular surgery unit.

  4. Tasting Arterial Blood: What do the Carotid Chemoreceptors Sense?

    Directory of Open Access Journals (Sweden)

    Nanduri R. Prabakhar

    2015-01-01

    Full Text Available The carotid bodies are sensory organs that detect the chemical composition of the arterial blood. The carotid body sensory activity increases in response to arterial hypoxemia and the ensuing chemoreflex regulates vital homeostatic functions. Recent studies suggest that the carotid bodies might also sense arterial blood glucose and circulating insulin levels. This review focuses on how the carotid bodies sense O2, glucose and insulin and some potential implications of these sensory functions on physiological regulation and in pathophysiological conditions. Emerging evidence suggests that carbon monoxide (CO-regulated hydrogen sulfide (H2S, stemming from hypoxia, depolarizes type I cells by inhibiting certain K+ channels, facilitates voltage-gated Ca2+ influx leading to sensory excitation of the carotid body. Elevated CO and decreased H2S renders the carotid bodies insensitive to hypoxia resulting in attenuated ventilatory adaptations to high altitude hypoxia, whereas reduced CO and high H2S result in hypersensitivity of the carotid bodies to hypoxia and hypertension. Acute hypoglycemia augments the carotid body responses to hypoxia but that a prolonged lack of glucose in the carotid bodies can lead to a failure to sense hypoxia. Emerging evidence also indicates that carotid bodies might sense insulin directly independent of its effect on glucose, linking the carotid bodies to the pathophysiological consequences of the metabolic syndrome. How glucose and insulin interact with the CO-H2S signalling is an area of ongoing study.KEY WORDS: Glomus cells, K+ channels, Carbon monoxide, hydrogen sulfide, hypoglycemia, diabetes.

  5. 单纯性肥胖儿童颈动脉参数%Correlation research on carotid artery parameter among the children with simple obesity

    Institute of Scientific and Technical Information of China (English)

    邬盛鑫; 马受良; 马君义; 郭春家; 杨巧玲; 方新林; 凌菊; 张平

    2011-01-01

    velocity and resistance index did not differ significantly ( P >0.05 ).The intima-media thickness increased with age, and there was no difference in carotid artery diameter ( P > 0.05).Conclusion BMI, blood pressure, high-density lipoprotein are correlated with carotid artery diameter, blood flow velocity and intima-media thickness.

  6. A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Zinman Bernard

    2005-06-01

    Full Text Available Abstract Background Subjects with type 2 diabetes are at an increased risk of vascular complications. The use of carotid ultrasound remains an attractive, non-invasive method to monitor atherosclerotic disease progression and/or response to treatment in patients with type 2 diabetes, with intima-media thickness routinely used as the gold standard to detect pathology. However, alternative measurements, such as plaque area or volume, may represent a potentially more powerful approach. Thus, the objective of this study was to compare the traditional intima-media thickness measurement against the novel total plaque volume measurement in analyzing carotid atherosclerosis development in individuals with type 2 diabetes. Methods The case-control study included 49 Oji-Cree adults with diabetes or impaired glucose tolerance, aged 21–69, and 49 sex- and age-matched normoglycemic subjects. At baseline, metabolic variables were measured, including body mass index, waist circumference, total cholesterol:high density lipoprotein ratio, plasma triglycerides, plasma glucose, and serum insulin. Carotid ultrasound measurements, 7 years later, assessed carotid arterial intima-media thickness and total plaque volume. Results At baseline, the two groups were well matched for smoking habits, hypertension, body mass index, and waist circumference. Differences were noted in baseline measurements of total cholesterol:high density lipoprotein (P = 0.0006, plasma triglycerides (P P P = 0.037, but not intima-media thickness measurements, were higher in subjects with diabetes/impaired glucose tolerance compared to the normoglycemic controls. Correlation between intima-media thickness and total plaque volume was moderate. Based on our study findings, to achieve power levels >0.70 when comparing intima-media thickness measurements for diabetics versus non-diabetics, thousands of study subjects are required. For comparing total plaque volume measurements, only hundreds of

  7. High Resolution Contrast-enhanced MRA in the Evaluation of Rabbit Carotid Artery

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Introduction:Accurate lumen definition of carotid artery is crucial for determining patient treatment, because a 70% or greater stenosis of a carotid artery will benefit from carotid endarterectomy to reduce the incidence of stroke[1].

  8. The history of surgical treatment for occlusive carotid artery diseases

    Directory of Open Access Journals (Sweden)

    Ding-biao ZHOU

    2014-01-01

    Full Text Available In this article, the history of surgical treatment for occlusive carotid artery diseases is briefly reviewed. It is emphasized that, after the results of large cohort, multicenter, randomized clinical trials, including North American Symptomatic Carotid Endarterectomy Trial (NASCET and European Carotid Surgery Trial (ECST, were reported in 1991, the important role of carotid endarterectomy (CEA for the surgical treatment of carotid atherosclerosis had already been confirmed. Although it has a late start in China, CEA has a bright and promising future.

  9. Relationship between Plasma Retinol-binding Protein 4 and Intima-media Thickness of Common Iliac Artery in Newly Diagnosed Type 2 Diabetics%新诊T2DM患者血浆RBP4与髂动脉内中膜厚度的关系研究

    Institute of Scientific and Technical Information of China (English)

    钟慧; 漆辉洲; 游咏; 陈雯; 冯聚玲; 谢娟; 李熠

    2014-01-01

    Objective To evaluate the relationship between the concentration of plasma retinol-binding protein 4 (RBP4) and intima-media thickness of common iliac artery (CIA-IMT) in newly diagnosed type 2 diabetic (T2DM) patients. Methods There were 180 newly diagnosed T2DM patients in study. Their plasma retinol-binding protein 4 level and other clinic index were tested. The patients were divided into three groups based on the concentrations of RBP4 to compare their CIA-IMT. The relevance of RBP4 and other parameters were analyzed by Pearson correlation analysis. Results CIA-IMT of RBP4 high tertile group was significantly thicker than other groups ( P<0.05). It is showed by Pearson correlation analysis that the concentration of RBP4 in T2DM patients is positively correlated with BMI, FBS, PBS, FINS and HOMA-IR.Conclusion CIA-IMT in newly diagnosed T2DM patients is closely correlated with plasma RBP4 levels.%目的:探讨新诊2型糖尿病(T2DM)患者血浆视黄醇结合蛋白4(RBP4)与髂动脉内中膜厚度(CIA-IMT)的关系。方法180例新诊T2DM患者测定血浆RBP4浓度、血糖、糖化血红蛋白(HbA1c)、血脂、胰岛素(FINS)及CIA-IMT,根据RBP4浓度由低到高按三分位法将180例患者分为三组,比较其CIA-IMT;用Pearson相关分析分析RBP4与其他指标的相关性。结果T2DM患者RBP4上三分位组CIA-IMT比其余两组增厚,差异有统计学意义(P<0.05);Pearson相关分析显示T2DM患者血浆RBP4与BMI、FBS、PBS、FINS及HOMA-IR呈正相关。结论新诊T2DM患者的血浆RBP4水平与CIA-IMT密切相关。

  10. Cognitive changes after carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Politi, M.; Struffert, T.; Krick, C.; Backens, M. [University of the Saarland, Department for Diagnostic and Interventional Neuroradiology, Homburg (Germany); Supprian, T.; Falkai, P.; Reith, W. [University of the Saarland, Clinic for Psychiatry and Psychotherapy, Homburg (Germany)

    2006-05-15

    We aimed to test changes in cognitive performance after carotid artery stenting (CAS). Ten patients were neuropsychologically tested at least 24 h before and 48 h after CAS. To diminish thromboembolic events, we used a proximal protection device. The following neuropsychological tests were selected: The Mini Mental State Examination (MMSE), symbol digit test and subtests of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery (verbal fluency, constructional practice, word list memory and delayed recall). Affective state was determined by the Beck Depression Score (BDS). No patient suffered from depression (BDS <1) or dementia (MMSE 29.9{+-}1.5). Nine of the ten patients (P=0.12) showed increased speed in the Number Connection Test (NCT) (corresponding to trail making test). Most patients showed better or similar results concerning delayed recall (P=0.31). No change was observed in the symbol digit test, word list memory, verbal fluency or constructional practice. Better results concerning NCT and delayed recall after carotid stenting might be due to improved brain perfusion. After CAS, cognitive and memory performance seem to improve. Further studies with different time intervals and more refined testing, as well as perfusion-weighted imaging, are needed. (orig.)

  11. Antibodies Against β2-Glycoprotein I Complexed With an Oxidised Lipoprotein Relate to Intima Thickening of Carotid Arteries in Primary Antiphospholipid Syndrome

    Directory of Open Access Journals (Sweden)

    P. R. J. Ames

    2006-01-01

    Full Text Available To explore whether antibodies against β2-glycoprotein I (β2GPI complexed to 7-ketocholesteryl-9-carboxynonanoate (oxLig-1 and to oxidised low-density lipoproteins (oxLDL relate to paraoxonase activity (PONa and/or intima media thickness (IMT of carotid arteries in primary antiphospholipid syndrome (PAPS. As many as 29 thrombotic patients with PAPS, 10 subjects with idiopathic antiphospholipid antibodies (aPL without thrombosis, 17 thrombotic patients with inherited thrombophilia and 23 healthy controls were investigated. The following were measured in all participants: β2GPI−oxLDL complexes, IgG anti-β2GPI−oxLig-1, IgG anti-β2GPI−oxLDL antibodies (ELISA, PONa, (para-nitrophenol method, IMT of common carotid (CC artery, carotid bifurcation (B, internal carotid (IC by high resolution sonography. β2GPI−oxLDL complex was highest in the control group (p < 0.01, whereas, IgG anti-β2GPI−oxLig1 and IgG anti-β2GPI−oxLDL were highest in PAPS (p < 0.0001. In healthy controls, β2GPI−oxLDL complexes positively correlated to IMT of the IC (p = 0.007 and negatively to PONa after correction for age (p < 0.03. PONa inversely correlated with age (p = 0.008. In PAPS, IgG anti-2GPI−oxLig-1 independently predicted PONa (p = 0.02 and IMT of B (p = 0.003, CC, (p = 0.03 and of IC (p = 0.04. In PAPS, PONa inversely correlated to the IMT of B, CC and IC (p = 0.01, 0.02 and 0.003, respectively. IgG anti-2GPI−oxLig-1 may be involved in PAPS related atherogenesis via decreased PON activity.

  12. Carotid artery access for transcatheter aortic valve replacement.

    Science.gov (United States)

    Guyton, Robert A; Block, Peter C; Thourani, Vinod H; Lerakis, Stamatios; Babaliaros, Vasilis

    2013-10-01

    We report three patients who had successful transcatheter aortic valve replacement (TAVR) via carotid artery access. None were candidates for thoracotomy (including minimal access incisions) and had no other vascular access sites that would accommodate the transcatheter valve sheath. Antegrade carotid perfusion and retrograde insertion of the delivery sheath maintained cerebral blood flow without sequelae. Carotid access for TAVR is an option for unusual patients without other access.

  13. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  14. Angiographic features of unilateral nonbifurcating cervical carotid artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    En, Na Lae [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Seung Koo [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    Nonbifurcating cervical carotid artery is a rare anomaly of the common carotid artery (CCA), in which the branches of the external carotid artery (ECA) arise directly from the CCA or proximal internal carotid artery without bifurcation, and therefore there is no proximal main trunk of the ECA. We report a unilateral nonbifurcating cervical carotid artery of a 67-year-old woman, incidentally found during cerebral aneurismal treatment.

  15. Carotid artery stenting by non-femoral arterial approach in patients with difficult anatomy

    Directory of Open Access Journals (Sweden)

    R V Narayana

    2013-01-01

    Full Text Available Background: Carotid endarterectomy (CEA and carotid artery stenting (CAS are safe, effective, and standard methods to treat significant carotid artery stenosis. CAS is generally performed through femoral arterial access. We had six patients with significant carotid artery stenosis, who had difficult anatomy prohibiting a trans-femoral CAS. Those patients were given an option for CEA. However, they refused for surgical intervention. Aim: We investigated the feasibility of performing CAS from a non-femoral arterial approach in patients with difficult anatomies like severe aortic/aorto-iliac disease, tortuous aortic arch, and tortuous carotid artery origin. Materials and Methods: Six patients with difficult anatomy presented to us with either transient ischemic attack or stroke with high-grade carotid artery stenosis. Out of the six patients, three had aorto-iliac disease, one had high-grade coarctation of aorta, two had tortuous aortic arch and or tortuous carotid artery origin. All these patients were treated with CAS though non-femoral arterial route. Results: CAS could be done successfully in all these six patients; four of them were done through trans-brachial arterial route and two were done through a direct carotid artery puncture. There were no new neurological deficits seen in any of the patient post-procedure. Conclusion: CAS can be done safely through non-femoral arterial approach in patients with difficult anatomy.

  16. Spontaneous carotid artery dissection causing a juvenile cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S.; Huebsch, P.; Schindler, E.

    1988-11-01

    The case of a 19-year-old patient is presented who was admitted with aphasia and hemiparesis due to basal ganglia infarction as a result of spontaneous dissection of the internal carotid artery. The difficulties in diagnosing this disease with CT and MRI in the acute stage are demonstrated. Angiography is still imperative in order to ascertain that a carotid dissection has occurred.

  17. Clustering of metabolic syndrome traits is associated with maladaptive carotid remodeling and stiffening: a 6-year longitudinal study.

    Science.gov (United States)

    Ferreira, Isabel; Beijers, Hanneke J; Schouten, Fleur; Smulders, Yvo M; Twisk, Jos W; Stehouwer, Coen D

    2012-08-01

    Maladaptive arterial remodeling may constitute a mechanism underlying the risk of stroke in individuals with the metabolic syndrome (MetS), but evidence supporting this contention derives from cross-sectional studies only. We, therefore, investigated, in apparently healthy adults, whether changes in MetS status between the ages of 36 and 42 years (never [n=207, reference group], incident [n=31], recovery [n=23], and persistent [n=32]) were associated with changes in carotid interadventitial diameter, lumen diameter, intima-media thickness, circumferential wall tension and stress, and Young's elastic modulus. All data analyses were adjusted for sex, height, and (changes in) age, lifestyle variables, low-density lipoprotein cholesterol, and use of antihypertensive medication. At baseline and as compared with the reference group, individuals with persistent MetS had significantly higher interadventitial diameter, circumferential wall tension, circumferential wall stress, and Young's elastic modulus but not intima-media thickness. In the course of follow-up, these individuals (versus reference group) displayed significantly steeper increases in intima-media thickness (0.011 versus 0.005 mm/y), which were accompanied by significantly steeper increases in interadventitial diameter (0.077 versus 0.032 mm/y) and lumen diameter (0.055 versus 0.023 mm/y) but not circumferential wall stress, which decreased (-0.34 versus 0.12 kPa/y). These findings suggest that increases in intima-media thickness in young adults with the MetS may primarily reflect an adaptive mechanism that attempts to restore local hemodynamic conditions to an equilibrium rather than atherosclerosis, per se. However, carotid adaptations did not restore circumferential wall stress to levels comparable with those of the reference group, and, therefore, outward remodeling was maladaptive. Importantly, individuals who recovered from the MetS restored carotid properties to levels comparable to the reference group

  18. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  19. Association between the Gensini Score and Carotid Artery Stenosis

    Science.gov (United States)

    Fidan, Serdar; Tabakçı, Mehmet Mustafa; Toprak, Cuneyt; Alizade, Elnur; Acar, Emrah; Bayam, Emrah; Tellice, Muhammet; Naser, Abdurrahman; Kargın, Ramazan

    2016-01-01

    Background and Objectives The aim of this study was to evaluate the association between the extent of coronary artery disease assessed by the Gensini score and/or the SYNTAX score and the significant carotid stenosis in patients undergoing coronary artery bypass grafting (CABG). Subjects and Methods A total of 225 patients who had carotid doppler ultrasonography prior to CABG were included retrospectively. Significant coronary artery disease was assumed as a lumen diameter stenosis of ≥50% in any of the major epicardial coronary arteries. The severity of carotid stenosis was determined by B-mode and duplex ultrasonography. Clinically significant carotid stenosis was defined as peak systolic velocity greater than 125 cm/s. Results The mean value of SYNTAX score and Gensini score was highest in patients allocated to significant carotid stenosis (22.98±7.32, p<0.001 and 77.40±32.35, p<0.001, respectively). The other risk factors for significant carotid stenosis were found to be male gender (p=0.029), carotid bruit (p<0.001), diabetes (p=0.021), left main disease (p=0.002), 3-vessel disease (p=0.008), chronic total coronary occlusion (p=0.001), and coronary artery calcification (p=0.001) in univariate analysis. However, only the Gensini score (odds ratio[OR]=1.030, p=0.004), carotid bruit (OR=0.068, p<0.001), and male gender (OR=0.190, p=0.003) were the independent predictors. The Gensini score cut off value predicting significant carotid stenosis was 50.5 with 77% sensitivity (p<0.001). Conclusion The Gensini score may be used to identify patients at high risk for significant carotid stenosis prior to CABG. PMID:27721854

  20. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis.......The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  1. Isolated supraclinoid occlusive disease of the internal carotid artery.

    Science.gov (United States)

    Lagrèze, H L; Hartmann, A; Ries, F; Wappenschmidt, J; Hanisch, E

    1987-01-01

    Isolated supraclinoid occlusive disease of the internal carotid artery is a rare cause of cerebral ischemia. The authors of the only review of this subject concluded that it is caused predominantly by factors other than atherosclerosis. We examined 6 patients with isolated supraclinoid occlusive lesions. Five of them had one or more risk factors for atherosclerosis. Thus, the isolated stenosis of that part of the internal carotid artery does not seem to represent a particular pathologic entity.

  2. Dissection of a non-bifurcating cervical carotid artery.

    Science.gov (United States)

    Nas, Omer Fatih; Karakullukcuoglu, Zeynel; Hakyemez, Bahattin; Erdogan, Cuneyt

    2016-06-01

    A non-bifurcating cervical carotid artery is a rare anomaly in the population. Radiologic diagnosis of pathologies seen together with this anomaly can be challenging. Despite not being diagnostic all the time, digital subtraction angiography is accepted as the gold standard method for the diagnosis of dissection. We present a case of a non-bifurcating cervical carotid artery and concomitant dissection, which presented to the hospital with trauma and ischemic findings.

  3. Bilateral hypoplasia of the internal carotid arteries with basilar aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, F.; Tortora, F.; Elefante, A. [Universita di Napoli Federico II, Dipartimento di Scienze Neurologiche, Cattedra di Neuroradiologia, 80131, Napoli (Italy); Maiuri, F. [Universita di Napoli Federico II, Department of Neurological Sciences, Neurosurgery Service, Napoli (Italy)

    2004-10-01

    We report a rare case of bilateral hypoplasia of the internal carotid arteries with an associated aneurysm of the basilar tip, studied by CT angiography, MR angiography and digital angiography. The patient became symptomatic with an episode of loss of consciousness, likely due to reduced blood perfusion. The other 20 reported cases of bilateral carotid hypoplasia (only four of which with an associated aneurysm) are reviewed. The findings of noninvasive procedures (including narrowing of the carotid canals on CT) may lead to a correct diagnosis before angiography is performed; they may also help to differentiate angiographic narrowing of the hypoplastic internal carotids from the string sign often observed in some acquired conditions. (orig.)

  4. EVALUATION OF CAROTID ARTERY STENOSIS IN STROKE/TRANSIENT ISCHAEMIC ATTACK

    OpenAIRE

    Nambakam Tanuja; Naveen Kumar; Girish P.

    2015-01-01

    BACKGROUND : Stroke remains the second leading cause of death worldwide, after ischaemic heart disease. Patients with carotid artery stenosis are at higher risk of development of stroke. Carotid atherosclerosis occurs in patients with atheros clerotic risk factors like diabetes mellitus, hypertension, smoking and hyperlipidemia. Carotid artery stenosis can be assessed by means of noninvasive high - resolution B - mode ultrasonography of the carotid arteries. ...

  5. The role of carotid artery stenting for recent cerebral ischemia.

    Science.gov (United States)

    Bosiers, M; Callaert, J; Deloose, K; Verbist, J; Keirse, K; Peeters, P

    2010-06-01

    Patients with cerebral ischemia as a result of acute cervical internal carotid artery occlusion are generally considered to have a poor prognosis. Despite maximal medical treatment, a better treatment for patients with acute ischemic stroke who present with serious neurologic symptoms on admission or continue to deteriorate neurologically due to a total occlusion, a dissection or a high-grade stenosis of the internal carotid artery is required. An effective intervention to improve their neurologic symptoms and clinical outcome has not yet been established and represents a challenging and complex problem. Treatment of acute symptomatic occlusion of the cervical internal carotid artery includes intravenous administration of thrombolytic agent, carotid endarterectomy and an interventional approach (intra-arterial administration of thrombolytic agent, transluminal angioplasty with or without stenting). The endovascular interventional approach is becoming a part of the stroke therapy armamentarium for intracranial occlusion. It may also now be considered in select patients with acute internal carotid artery occlusion. Stenting and angioplasty for acute internal carotid artery occlusion appears to be feasible, safe and may be associated with early neurological improvement. The encouraging preliminary results await confirmation from prospective, randomized studies.

  6. Occlusion of Internal Carotid Artery in Kimura's Disease

    Directory of Open Access Journals (Sweden)

    Tomonori Tamaki

    2010-01-01

    Full Text Available We describe a unique case of Kimura's disease in which cerebral infarction was caused by occlusion of the right internal carotid artery. A 25-year-old man with Kimura's disease was admitted to our hospital because of left hemiparesis. Computed tomography and magnetic resonance imaging of the head showed infarction in the right frontal and temporal lobes. Cerebral angiography demonstrated right internal carotid artery occlusion affecting the C1 segment, with moyamoya-like collateral vessels arising from the right opthalamic artery. Kimura's disease is a chronic disease characterized by the clinical triad of slowly enlarging subcutaneous masses with lymphoid hyperplasia in the head and neck. It often occurs in young Asian men. In our patient, the pathogenesis of internal carotid artery occlusion was unknown. There have only been a few case reports in which occlusion of the internal carotid artery was associated with autoimmune disease, and no previous cases of internal carotid occlusion associated with Kimura's disease have been reported. We suspected that occlusion of this patient's internal carotid artery may be caused by the autoimmune mechanism that underlies Kimura's disease.

  7. [The effect of carotid endarterectomy on cognitive disturbances in patients with atherosclerotic stenosis of carotid arteries].

    Science.gov (United States)

    Iakhno, N N; Fedorova, T S; Damulin, I V; Shcherbiuk, A N; Vinogradov, O A; Lavrent'ev, A V

    2011-01-01

    Clinical and neuropsychological features of non-dementia cognitive disturbances were studied in 102 patients with atherosclerotic carotid stenosis. Cognitive disturbances were assessed after the carotid endarterectomy (CEAE). Mild cognitive impairment was found in 37 (36,3%) of patients, moderate cognitive impairment was diagnosed in 36 (35,3%)patients. Moderate cognitive impairment was found more often in patients with symptomatic carotid stenosis with structural brain changes confirmed by neuroimaging data and with instable atherosclerotic plaques with the predomination of hypodensity component. It allows to suggest that both the reduction of perfusion and arterio-arterial microemboli may cause cognitive dysfunction in patients with atherosclerotic carotid stenosis. The data on the positive effect of CEAE on cognitive functions have been obtained. The positive changes were more distinct in patients with asymptomatic course of carotid stenosis. However CEAE may have a negative effect on cognitive functions in patients with moderate cognitive impairment of dysmnestic character and symptomatic carotid stenosis.

  8. Carotid Artery Management in Head and Neck Surgery

    Directory of Open Access Journals (Sweden)

    Murat Haluk Özkul

    2014-06-01

    Full Text Available Prevention and management of intraoperative and postoperative bleeding are of a great importance in performing successful head and neck surgery. Since the carotid artery is the major source of cerebral vascular supply, the management of carotid artery diseases including replacement, when needed, necessitates special knowledge and skill as well as experience. Delayed postoperative hemorrhage usually comes from carotid artery due to increasing frequency of radiotherapy treatment of head and neck cancers nowadays. This is the most catastrophic complication of the head and neck surgery. Carotid resection can be planned as part of surgical treatment or salvage. Carotid resection is performed mostly to salvage patients when radiotherapy and chemotherapy are ineffective and less for carotid invasion caused by either direct extension of a malign tumor originating from the nasopharynx and oropharynx or extracapsular invasion of advanced jugular node metastasis. The purpose of this presentation was to enlighten the readers about carotid artery problems and management emphasizing the importance of preoperative evaluation. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 71-4

  9. A PROSPECTIVE STUDY OF LONG TERM EFFECT OF STATINS ON DYSLIPIDAEMIA, INTIMA-MEDIA THICKNESS AND C-REACTIVE PROTEIN IN TYPE-2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Sudheer

    2015-11-01

    Full Text Available Dyslipidaemia is one of the major risk factor for cardio vascular disease in diabetes mellitus. Lipid abnormalities in type 2 diabetes mellitus are characterised by high triglyceride concentration low HDL concentration and normal total and low density lipo–protein cholesterol (LDL–c concentration. Present study is a prospective study to evaluate the effect of statin on Dyslipidemia and the markers of atherosclerosis in type–2 diabetes mellitus. Metformin and Rosuvastatin have good effect on lipid profile and hs-CRP. But the response on the decrease in thickness of common carotid intima-media, result was statistically significant but not as per the expectation

  10. Effect of sedentary behaviour and vigorous physical activity on segment-specific carotid wall thickness and its progression in a healthy population.

    LENUS (Irish Health Repository)

    2010-06-01

    This study investigated whether sedentary behaviour and different activity levels have an independent association with carotid intima-media thickness (IMT) and with the 3-year IMT progression in different carotid segments.

  11. Carotid artery occlusion by rhinoorbitocerebral mucormycosis.

    Science.gov (United States)

    Al-Otaibi, Faisal; Albloushi, Monirah; Alhindi, Hindi; Timms, Michael S

    2012-01-01

    Mucormycosis is the third most common invasive fungal infection that particularly occurs in immunocompromised patients. Intracranial and extracranial arteriovenous vasculopathy is a complication that makes this disease more complex and difficult to treat. We describe a 23-year-old female, who presented to her local hospital with acute blindness and diabetic ketoacidosis-induced coma requiring intensive care treatment. She was found to have lesions in the nasal sinuses, orbit, and frontal base. The left carotid artery was occluded from its origin in the neck to the supraclinoid segment and left cavernous sinus involvement. No cerebral infarction was noted. Biopsies obtained by endonasal debridement confirmed mucormycosis. In addition to antimicrobial therapy, she underwent several multidisciplinary approaches to treat her disease. Multiple endonasal, and cranial procedures were done including bilateral orbital exenteration. After prolonged treatment on the intensive care unit she made a remarkable recovery to the point where she was communicating verbally and had normal limb movements and later discharged home. She remained alive and well for two months, but later succumbed to a recurrence of her disease. In conclusion, mucormycosis-induced vasculopathy is a complex problem, which merits aggressive treatment of this invasive disease. It is normally regarded as an indicator of grave prognosis.

  12. Carotid Artery Occlusion by Rhinoorbitocerebral Mucormycosis

    Directory of Open Access Journals (Sweden)

    Faisal Al-Otaibi

    2012-01-01

    Full Text Available Mucormycosis is the third most common invasive fungal infection that particularly occurs in immunocompromised patients. Intracranial and extracranial arteriovenous vasculopathy is a complication that makes this disease more complex and difficult to treat. We describe a 23-year-old female, who presented to her local hospital with acute blindness and diabetic ketoacidosis-induced coma requiring intensive care treatment. She was found to have lesions in the nasal sinuses, orbit, and frontal base. The left carotid artery was occluded from its origin in the neck to the supraclinoid segment and left cavernous sinus involvement. No cerebral infarction was noted. Biopsies obtained by endonasal debridement confirmed mucormycosis. In addition to antimicrobial therapy, she underwent several multidisciplinary approaches to treat her disease. Multiple endonasal, and cranial procedures were done including bilateral orbital exenteration. After prolonged treatment on the intensive care unit she made a remarkable recovery to the point where she was communicating verbally and had normal limb movements and later discharged home. She remained alive and well for two months, but later succumbed to a recurrence of her disease. In conclusion, mucormycosis-induced vasculopathy is a complex problem, which merits aggressive treatment of this invasive disease. It is normally regarded as an indicator of grave prognosis.

  13. Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

    Institute of Scientific and Technical Information of China (English)

    Ze-Zhou; Song; Yan-Ming; Zhang

    2015-01-01

    The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.

  14. [Is there a role for asymptomatic carotid artery stenosis screening?].

    Science.gov (United States)

    Heldenberg, Eitan; Bass, Arie

    2014-08-01

    Screening for asymptomatic carotid artery stenosis (CAS) is highly controversial Many surgeons routinely screen their patients for carotid disease prior to major operations, yet the benefit of such practice was never demonstrated. The treatment of symptomatic patients has not changed much during the last twenty years, since the publication of the North American Symptomatic Carotid Endarterectomy Trial (NASCET). However, in contrast, the Asymptomatic Carotid Atherosclerosis Study (ACAS) and the Asymptomatic Carotid Surgery Trial (ACST) failed to get the same acceptance among the multidisciplinary group treating CAS.The prevalence of asymptomatic 60-99% carotid artery stenosis among the general population is about 1%. Neither ACAS nor ACST showed that stenosis severity was associated with increasing stroke risk. The 'realpolitik' is that mass interventions in asymptomatic patients will probably only ever prevent about 1% of all strokes. This is even truer regarding patients scheduLed for major operation, in which the incidence of stroke is less than 1%. Moreover the current evidence in the literature suggests that the best medicaL treatment (BMT) results in 0.5% strokes per year, better than resuLts which can be offered by surgery. According to the current evidence, it seems that asymptomatic carotid artery screening should be discontinued, since it is a major waste of resources.

  15. Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography.

    Science.gov (United States)

    Omoto, Shusaku; Hasegawa, Yuki; Sakai, Kenichiro; Matsuno, Hiromasa; Arai, Ayumi; Terasawa, Yuka; Mitsumura, Hidetaka; Iguchi, Yasuyuki

    2016-10-01

    Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy.

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  11. Radioiodine Therapy Does Not Change the Atherosclerotic Burden of the Carotid Arteries

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Andersen, Ulrik Bjørn; Sørensen, Christian Hjort

    2016-01-01

    of cerebrovascular events has been reported after radioiodine therapy. This study aimed to examine whether atherosclerosis develops early or late after radioiodine therapy of benign thyroid disease. METHOD: Patients treated for benign thyroid disorders (nontoxic goiter, adenoma, and hyperthyroidism) were examined...... with ultrasound for the main outcome, carotid intima media thickness (CIMT), and for plaque presence (plaque presence only in late damage). Signs of early damage from radioiodine were studied in 39 radioiodine-treated patients, who were examined before treatment and at 1, 3, 6, and 12 months after treatment. Late...... were adjusted for age, sex, cholesterol, smoking status, known atherosclerotic disease, and body mass index. RESULTS: No changes in CIMT were found in the patients followed prospectively for one year after treatment with radioactive iodine for benign thyroid disease (p = 0.58). In the study on late...

  12. Endovascular Management of Long-Segmental Petrocavernous Internal Carotid Artery (Carotid S) Occlusion

    OpenAIRE

    Park, Soonchan; Park, Eun Suk; Kwak, Jae Hyuk; Lee, Dong-geun; Suh, Dae Chul; Kwon, Sun U.; Lee, Deok Hee

    2015-01-01

    Background and Purpose Long-segmental thrombotic occlusion of the distal internal carotid artery (ICA) sparing the cervical segment proximally and the supraclinoid segment distally, which could be termed ’Carotid S occlusion’, has an unusual clinical presentation. However, endovascular management of this lesion is challenging. The purpose of our study is to report our endovascular treatment clinical experience of the disease. Methods From March 2008 to June 2013, we could identify 14 patients...

  13. Increased LDL susceptibility to oxidation accelerates future carotid artery atherosclerosis

    Directory of Open Access Journals (Sweden)

    Aoki Toshinari

    2012-01-01

    Full Text Available Abstract Background We analyzed the causal relationship between LDL susceptibility to oxidation and the development of new carotid artery atherosclerosis over a period of 5 years. We previously described the determinants related to a risk of cardiovascular changes determined in a Japanese population participating in the Niigata Study, which is an ongoing epidemiological investigation of the prevention of cardiovascular diseases. Methods We selected 394 individuals (169 males and 225 females who underwent a second carotid artery ultrasonographic examination in 2001 - 2002 for the present study. The susceptibility of LDL to oxidation was determined as the photometric absorbance and electrophoretic mobility of samples that had been collected in 1996 - 1997. The measurements were compared with ultrasonographic findings obtained in 2001 - 2002. Results The multivariate-adjusted model showed that age (odds ratio (OR, 1.034; 95% confidence interval (95%CI, 1.010 - 1.059, HbA1c (OR, 1.477; 95%CI, 0.980 - 2.225, and photometric O/N (OR, 2.012; 95%CI, 1.000 - 4.051 were significant variables that could independently predict the risk of new carotid artery atherosclerosis. Conclusion The susceptibility of LDL to oxidation was a significant parameter that could predict new carotid artery atherosclerosis over a 5-year period, and higher susceptibility was associated with a higher incidence of new carotid artery atherosclerosis.

  14. Skin autofluorescence is increased in patients with carotid artery stenosis and peripheral artery disease.

    Science.gov (United States)

    Noordzij, Marjon J; Lefrandt, Joop D; Loeffen, Erik A H; Saleem, Ben R; Meerwaldt, Robbert; Lutgers, Helen L; Smit, Andries J; Zeebregts, Clark J

    2012-02-01

    Advanced glycation end products (AGEs) have a pivotal role in atherosclerosis. We evaluated skin autofluorescence (SAF), a non-invasive measurement of tissue AGE accumulation, in patients with carotid artery stenosis with and without coexisting peripheral artery occlusive disease (PAOD). SAF was measured using the AGE Reader™ in 56 patients with carotid artery stenosis and in 56 age- and sex-matched healthy controls without diabetes, renal dysfunction or known atherosclerotic disease. SAF was higher in patients with carotid artery stenosis compared to the control group: mean 2.81 versus 2.46 (P = 0.002), but especially in the younger age group of 50-60 years old: mean 2.82 versus 1.94 (P = 0.000). Patients with carotid artery stenosis and PAOD proved to have an even higher SAF than patients with carotid artery stenosis only: mean 3.28 versus 2.66 (P = 0.003). Backward linear regression analysis showed that age, smoking, diabetes mellitus, renal function and the presence of PAOD were the determinants of SAF, but carotid artery stenosis was not. SAF is increased in patients with carotid artery stenosis and PAOD. The univariate and multivariate associations of SAF with age, smoking, diabetes, renal insufficiency and PAOD suggest that increased SAF can be seen as an indicator of widespread atherosclerosis.

  15. Cardioembolic occlusion of the internal carotid artery presented with infarction in the posterior cerebral artery territory

    Institute of Scientific and Technical Information of China (English)

    XUE Su-fang; JIA Jian-ping

    2010-01-01

    @@ Posterior circulation stroke may rarely be associated with occlusive disease in the anterior circulation, such as in the context of a direct (fetal) origin of the posterior cerebral artery (PCA) from the internal carotid artery (ICA), or in the presence of a persistent trigeminal artery (PTA) or persistent hypoglossal artery (PHA).1,2

  16. Carotid artery stenting: Rationale, technique, and current concepts

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, Hasan, E-mail: hasan.yilmaz@hcuge.c [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes; Narata, Ana-Paula [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland); Sztajzel, Roman [Department of Neurology, University Hospital of Geneva (Switzerland); Lovblad, Karl-Olof [Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva (Switzerland)

    2010-07-15

    Carotid stenosis is a major risk factor for stroke. With the aging of the general population and the availability of non-invasive vascular imaging studies, the diagnosis of a carotid plaque is commonly made in medical practice. Asymptomatic and symptomatic carotid stenoses need to be considered separately because their natural history is different. Two large randomized controlled trials (RCTs) showed the effectiveness of carotid endarterectomy (CEA) in preventing ipsilateral ischemic events in patients with symptomatic severe stenosis. The benefit of surgery is much less for moderate stenosis and harmful in patients with stenosis less than 50%. Surgery has a marginal benefit in patients with asymptomatic stenosis. Improvements in medical treatment must be taken into consideration when interpreting the results of these previous trials which compared surgery against medical treatment available at the time the trials were conducted. Carotid artery stenting (CAS) might avoid the risks associated with surgery, including cranial nerve palsy, myocardial infarction, or pulmonary embolism. Therefore and additionally to well-established indications of CAS, this endovascular approach might be a valid alternative particularly in patients at high surgical risk. However, trials of endovascular treatment of carotid stenosis have failed to provide enough evidence to justify routine CAS as an alternative to CEA in patients suitable for surgery. More data from ongoing randomized trials of CEA versus CAS will be soon available. These results will help determining the role of CAS in the management of patients with carotid artery stenosis.

  17. Associations between bicycling and carotid arterial stiffness in adolescents

    DEFF Research Database (Denmark)

    Ried-Larsen, M; Grøntved, A; Østergaard, Lars;

    2015-01-01

    The aim of the study was to investigate the associations between bicycling and carotid arterial stiffness, independent of objectively measured moderate-and-vigorous physical activity. This cross-sectional study included 375 adolescents (age 15.7 ± 0.4 years) from the Danish site of the European...... Youth Heart Study. Total frequency of bicycle usage was assessed by self-report, and carotid arterial stiffness was assessed using B-mode ultrasound. After adjusting for pubertal status, body height, and objectively measured physical activity and other personal lifestyle and demographic factors, boys...... modulus [standard beta -0.48 (95% CI -0.91 to -0.06)]. Similar trends were observed when investigating the association between commuter bicycling and carotid arterial stiffness. These associations were not observed in girls. Our observations suggest that increasing bicycling in adolescence may...

  18. Carotid artery stenting: which stent for which lesion?

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen; Verbist, Jürgen; Peeters, Patrick

    2005-01-01

    The different geometries and working principles of carotid stents (nitinol or cobalt chromium, open- or closed-cell configuration) provide each product with unique functional properties. The individual characteristics of each device may make it an attractive choice in one circumstance but render it less desirable in other situations. In approximately 75% of all procedures, all types of stents will achieve similar outcomes, making adequate device selection unnecessary. For the remaining quarter, careful preoperative screening is mandatory. In addition to eventual access issues, the choice of the optimal carotid stent depends mainly on arterial anatomy and lesion morphology. When treating a tortuous anatomy, stents with a flexible and comformable open-cell configuration are preferred. In arteries with a significant mismatch between common carotid artery and internal carotid artery diameter, cobalt chromium (Elgiloy) or tapered nitinol stents are selected. Lesions with suspected high emboligenicity are best covered with stents with a closed-cell configuration, whereas highly calcified lesions need treatment with nitinol stents. Thorough knowledge of the characteristics, advantages and disadvantages, and working principles of the different available stents is mandatory to optimally select the materials to be used for patients eligible for carotid revascularization.

  19. [Injuries of the intracranial part of the carotid artery].

    Science.gov (United States)

    Sulla, I; Kafka, J; Mach, P; Výrostko, J; Kat'uch, V

    2000-07-01

    The objective of the submitted work was to draw attention to different types of injuries of the intracranial portion of the carotid artery and some problems associated with its solution. The investigated group comprised 7 subjects (2 women, 5 men) aged 19 to 76 years who attended between Jan. 1, 1995 and Feb. 29 2000 the Neurosurgical Clinic in Kosice with sequelae of injuries of the intracranial carotid artery. Two patients developed a pseudoaneurysm. In one case it was manifested by subarachnoid haemorrhage on the 24th day after a crash, in one instance by diplopia six weeks after a retrobulbar injection. Injury of the intracavernous portion of the artery was manifested in one instance by profuse epistaxis on the 17th day after a fall from a bicycle, four times by the development of a carotid-cavernous fistula several days to 3 years after the head injury. In the diagnosis classical as well as MR and digital subtraction angiography were used. In the patient with epistaxis classical carotid angiography was 3 times negative. The results are comparable with data in the literature. In three patients the problem was resolved by ligature of the common carotid artery on the neck. In another three it was necessary to use extra-intracranial trapping. One patient will be subjected to endovascular surgery. Two patients died (a 76-year-old woman from bronchopneumonia, a 19-year-old man from meningitis, despite a liquor fistula treated correctly by a patch).

  20. Correlation analysis between the carotid artery ather osclerosis severity of patients with lacunar infarct and the level of serum uric acid, high-sensitivity C-reactive protein

    Directory of Open Access Journals (Sweden)

    WANG Shu

    2013-01-01

    Full Text Available Background Nowadays, clinical practice shows that the number of patients with cerebral infarction increases year by year in young and middle-aged adults with unclear causes. This paper aims to investigate the correlation between the level of serum uric acid (UA, high-sensitivity C-reactive protein (hsCRP and the degree of carotid atherosclerosis by detecting the level of UA, hsCRP and carotid intima-media thickness (IMT in young and middle-aged patients with lacunar infarct. Methods By using Holland Philips HT-11 color Doppler ultrasonic diagnostic apparatus with linear type probe and 7.50MHz frequency, IMT of end-diastolic distal and bifurcation of arteria carotis communis and proximal internal carotid artery were measured respectively on 186 patients with definitely diagnosed lacunar infarct. As a result, average values were taken as the IMT values. IMT < 1.00 mm was regarded as negative result and 1.00 mm ≤IMT < 1.20 mm was thickening of carotid artery intima. Carotid artery plaque formation was regarded with echo structure existing in the lumen or abnormal blood flow deficits into the lumen, or local IMT ≥1.20 mm at vertical and horizontal scan. At the same time, the levels of UA and hsCRP were detected, and correlation analysis was made between them and IMT. Results The values of UA, hsCRP and IMT in the case group were higher than that in the control group (P = 0.000. The differences among the case subgroups including IMT thickening group, plaque formation group and IMT normal group were statistically significant (P < 0.01, for all. There was linear correlation between the levels of UA, hsCRP and IMT ( r = 0.923, P = 0.000; r = 0.955, P = 0.008. Conclusion UA and hsCRP involve in the formation of atherosclerosis plaque and play an important role in the first-onset lacunar infarct patients without hypertension and other risk factors.

  1. Tissue Characterization on Common Carotid Artery using AR Model

    Science.gov (United States)

    Koya, Yoshiharu; Mizoshiri, Isao

    This study uses one image with a echocardiography and detects arteriosclerosis on the common carotid artery by tissue characterization. The conventional methods are measurement of thickness on the vessel wall or stiffness on the common carotid artery. However, they need frames of several beats and great calculation times. But, we detect the arteriosclerosis with only one image. Our method estimate the grade of arteriosclerosis by AR model parameters fitted to the texture on the lumen-intima wall. Experimental results show the validity of the proposed method.

  2. File list: DNS.CDV.10.AllAg.Carotid_Arteries [Chip-atlas[Archive

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    Lifescience Database Archive (English)

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  10. Determinants of Functional and Structural Properties of Large Arteries in Healthy Individuals

    Energy Technology Data Exchange (ETDEWEB)

    Tolezani, Elaine Cristina; Costa-Hong, Valéria, E-mail: hong.valeria@gmail.com; Correia, Gustavo; Mansur, Alfredo José; Drager, Luciano Ferreira; Bortolotto, Luiz Aparecido [Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

    2014-11-15

    Changes in the properties of large arteries correlate with higher cardiovascular risk. Recent guidelines have included the assessment of those properties to detect subclinical disease. Establishing reference values for the assessment methods as well as determinants of the arterial parameters and their correlations in healthy individuals is important to stratify patients. To assess, in healthy adults, the distribution of the values of pulse wave velocity, diameter, intima-media thickness and relative distensibility of the carotid artery, in addition to assessing the demographic and clinical determinants of those parameters and their correlations. This study evaluated 210 individuals (54% women; mean age, 44 ± 13 years) with no evidence of cardiovascular disease. The carotid-femoral pulse wave velocity was measured with a Complior{sup ®} device. The functional and structural properties of the carotid artery were assessed by using radiofrequency ultrasound. The means of the following parameters were: pulse wave velocity, 8.7 ± 1.5 m/s; diameter, 6,707.9 ± 861.6 μm; intima-media thickness, 601 ± 131 μm; relative distensibility, 5.3 ± 2.1%. No significant difference related to sex or ethnicity was observed. On multiple linear logistic regression, the factors independently related to the vascular parameters were: pulse wave velocity, to age (p < 0.01) and triglycerides (p = 0.02); intima-media thickness, to age (p < 0.01); diameter, to creatinine (p = 0.03) and age (p = 0.02); relative distensibility, to age (p < 0.01) and systolic and diastolic blood pressures (p = 0.02 and p = 0.01, respectively). Pulse wave velocity showed a positive correlation with intima media thickness (p < 0.01) and with relative distensibility (p < 0.01), while diameter showed a positive correlation with distensibility (p = 0.03). In healthy individuals, age was the major factor related to aortic stiffness, while age and diastolic blood pressure related to the carotid functional measure

  11. Cone pathway function in relation to asymmetric carotid artery stenosis

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Munch, Inger Christine; Holfort, Stig K;

    2013-01-01

    in the same patient. Results:  Ophthalmic systolic pressure was 95.8 ± 13.1 mmHg on the side with the highest degree of carotid artery stenosis (mean 94.0%) and 111.7 ± 10.3 mmHg in the fellow eyes on the side with the lesser degree of stenosis (mean 33.9%). Summed mfERG implicit times (N1 and P1) were 3......Purpose:  To examine retinal function in relation to retinal perfusion pressure in patients with carotid artery stenosis. Methods:  Thirteen patients with carotid artery stenosis without clinical eye disease underwent assessment of ophthalmic artery systolic blood pressure (OSP) by ocular...... pneumoplethysmography, carotid artery obstructive disease by ultrasonography, intraocular pressure by applanation tonometry, retinal perfusion by fluorescein angiography and retinal function by multifocal electroretinography (mfERG). Data analysis compared the eye on the most stenotic side with the fellow eye...

  12. Case of radiation induced aneurysm of extracranial carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Takashi; Ikota, Toshio; Yamashita, Kousuke; Kodama, Takao

    1988-08-01

    An unusual case of post-irradiation aneurysm of extracranial internal carotid artery is presented. A 70-year-old man, complaining of left cervical throbbing mass with focal pain, was admitted on February 8, 1985. It was noted, from his past history, that he had had surgery of the removal of cervical lymphnodes and that unknown dosage of irradiation had been added to the cervical region 30 years before. Left carotid angiography (on admission) demonstrated a giant aneurysm in the cervical portion of internal carotid artery. Right carotid angiography with compression of left carotid artery revealed good cross filling through anterior communicating artery. Computed tomography with contrast media showed a ring like enhanced mass, which was thought to suggest that a large part of the aneurysm was filled with intraluminal thrombosis. During 30 days of evaluation, the aneurysm grew larger and his cervical pain became untolerable. Operation, the resection of the aneurysm and the reconstruction (of circulation) with vein graft, was challenged on March 12. It was so difficult with meticulous work that the ligation of left common carotid artery was performed after all. Seven days after the operation, he suffered from the gastrointestinal bleeding, which was enough to lead him to hypovolemic shock. Thereafter, right hemiparesis and aphasia were brought about. Two months later, he died of pneumonia. On histological examination, it was demonstrated that the aneurysm communicated with the necrotic tissue and that the normal structure of the blood vessel was not observed in the aneurysmal wall and consisted of the collagenous fiber and granulated tissue. The aneurysm was interpreted as a false one.

  13. Carotid Endarterectomy for Symptomatic Complete Occlusion of the Internal Carotid Artery

    Directory of Open Access Journals (Sweden)

    Cho,Yong-Pil

    2011-08-01

    Full Text Available We described 9 consecutive patients who underwent operative carotid artery exploration with attempted carotid endarterectomy (CEA for symptomatic internal carotid artery (ICA occlusion. Indications for this surgery based on vascular imaging included segmental occlusion of the proximal ICA and also extensive occlusion of the distal ICA in selected patients in whom color-flow duplex ultrasound showed a poorly echogenic or anechoic thrombus with a flow void, suggestive of an acute thrombus. CEA was performed successfully to restore blood flow in all 9 patients:CEA in 5 and CEA with Fogarty thrombectomy in 4. Postoperative magnetic resonance (MR angiography confirmed that revascularization had been successful in all 9 patients, and MR imaging displayed improved perfusion in 4 patients. Despite the lack of a generalized efficacy of surgical revascularization for symptomatic ICA occlusion, our study demonstrated that preoperative vascular imaging allows the selection of patients who may benefit from CEA.

  14. Doppler examination of the periorbital arteries adds valuable hemodynamic information in carotid artery disease

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T; Steenberg, H J;

    1987-01-01

    The periorbital flow direction and internal carotid artery (ICA) angiogram were compared to the ICA pressure gradient across the stenosis and the distal ICA pressure in 51 patients subjected to carotid endarterectomy. All 17 patients with inverted periorbital flow had stenoses exceeding 50%. The ...

  15. Study on the screening program and risk factors of carotid artery stenosis with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李庆祥

    2013-01-01

    Objective The purpose of this research project was to evaluate the relationship and risk factors between coronary artery disease and carotid artery stenosis (CAS) ,screened by duplex ultra-sonography.Methods 1339 patients with coronary artery disease were enrolled into this

  16. MIGRAINE, CAROTID STIFFNESS AND GENETIC POLYMORPHISM.

    Science.gov (United States)

    Kes, Vanja Basić; Jurasić, Miljenka-Jelena; Zavoreo, Iris; Corić, Lejla; Rotim, Kresimir

    2015-12-01

    Recently migraine has been associated with increased arterial stiffness, procoagulant state, increased incidence of cerebral white matter lesions (WML) and stroke. Our aim was to compare the characteristics of migraineurs to headache free controls regarding their functional carotid ultrasound parameters. Sixty patients (45 women) with migraine (mean age 40.42 ± 10.61 years) were compared with 45 controls (30 women) with no prior history of repeating headache (mean age 38.94 ± 5.46 years) using E-tracking software on Alpha 10 ultrasound platform. Student's t-test was used on statistical analysis with alpha < 0.05. All tested carotid vascular parameters were worse in patients with migraine including increased intima-media thickness, greater carotid diameter and carotid diameter change, as well as several arterial stiffness indices. Additionally, patients with migraine had greater incidence of homozygous mutations for procoagulant genes (MTHFR (C677T), PAI-1 and ACE I/D) than expected. Computed tomography and magnetic resonance imaging of the brain showed WML in 11 patients, four of them migraine with aura patients. Since we established increased carotid stiffness and higher frequency of procoagulant gene mutations in migraineurs, we propose prospective ultrasound monitoring in such patients, especially those with detected WML, in order to timely commence more active and specific preventive stroke management strategies.

  17. A Parallel Lattice Boltzmann Model of a Carotid Artery

    Science.gov (United States)

    Boyd, J.; Ryan, S. J.; Buick, J. M.

    2008-11-01

    A parallel implementation of the lattice Boltzmann model is considered for a three dimensional model of the carotid artery. The computational method and its parallel implementation are described. The performance of the parallel implementation on a Beowulf cluster is presented, as are preliminary hemodynamic results.

  18. Intima-Media Thickness Measurements in the Fetus and Mother During Pregnancy

    DEFF Research Database (Denmark)

    Galjaard, Sander; Pasman, Suzanne A; Ameye, Lieveke

    2014-01-01

    arterial locations to determine vascular changes that could be associated with impaired vascular function. IMT was measured from the first to third trimester (12-34 wk), in 38 low-risk pregnancies. We imaged a 10-mm region of interest using a Mindray (Shenzhen, China) high-resolution ultrasound machine...... with automated IMT measurement software. Fetal abdominal aorta IMT was measurable during the second trimester in 71% and during the third trimester in 100% of the case, and umbilical artery IMT was measurable in 50% and 82% of cases during the second and third trimesters, respectively. Fetal IMT measurements...... were not possible during the first trimester. It was not often feasible to measure the IMT of the fetal common carotid artery, fetal renal artery and maternal iliac artery (maximal 20% of cases). Maternal common carotid artery, abdominal aorta and uterine artery IMTs were measurable throughout...

  19. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Kachel, R.; Basche, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Radiologische Klinik); Heerklotz, I.; Grossmann, K. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Innere Medizin); Endler, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Neurologie und Psychiatrie)

    1991-06-01

    We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.).

  20. Computational Analysis on Stent Geometries in Carotid Artery: A Review

    Science.gov (United States)

    Paisal, Muhammad Sufyan Amir; Taib, Ishkrizat; Ismail, Al Emran

    2017-01-01

    This paper reviews the work done by previous researchers in order to gather the information for the current study which about the computational analysis on stent geometry in carotid artery. The implantation of stent in carotid artery has become popular treatment for arterial diseases of hypertension such as stenosis, thrombosis, atherosclerosis and embolization, in reducing the rate of mortality and morbidity. For the stenting of an artery, the previous researchers did many type of mathematical models in which, the physiological variables of artery is analogized to electrical variables. Thus, the computational fluid dynamics (CFD) of artery could be done, which this method is also did by previous researchers. It lead to the current study in finding the hemodynamic characteristics due to artery stenting such as wall shear stress (WSS) and wall shear stress gradient (WSSG). Another objective of this study is to evaluate the nowadays stent configuration for full optimization in reducing the arterial side effect such as restenosis rate after a few weeks of stenting. The evaluation of stent is based on the decrease of strut-strut intersection, decrease of strut width and increase of the strut-strut spacing. The existing configuration of stents are actually good enough in widening the narrowed arterial wall but the disease such as thrombosis still occurs in early and late stage after the stent implantation. Thus, the outcome of this study is the prediction for the reduction of restenosis rate and the WSS distribution is predicted to be able in classifying which stent configuration is the best.

  1. Wavelet-based neural network analysis of internal carotid arterial Doppler signals.

    Science.gov (United States)

    Ubeyli, Elif Derya; Güler, Inan

    2006-06-01

    In this study, internal carotid arterial Doppler signals recorded from 130 subjects, where 45 of them suffered from internal carotid artery stenosis, 44 of them suffered from internal carotid artery occlusion and the rest of them were healthy subjects, were classified using wavelet-based neural network. Wavelet-based neural network model, employing the multilayer perceptron, was used for analysis of the internal carotid arterial Doppler signals. Multi-layer perceptron neural network (MLPNN) trained with the Levenberg-Marquardt algorithm was used to detect stenosis and occlusion in internal carotid arteries. In order to determine the MLPNN inputs, spectral analysis of the internal carotid arterial Doppler signals was performed using wavelet transform (WT). The MLPNN was trained, cross validated, and tested with training, cross validation, and testing sets, respectively. All these data sets were obtained from internal carotid arteries of healthy subjects, subjects suffering from internal carotid artery stenosis and occlusion. The correct classification rate was 96% for healthy subjects, 96.15% for subjects having internal carotid artery stenosis and 96.30% for subjects having internal carotid artery occlusion. The classification results showed that the MLPNN trained with the Levenberg-Marquardt algorithm was effective to detect internal carotid artery stenosis and occlusion.

  2. Electrical carotid sinus stimulation in treatment resistant arterial hypertension.

    Science.gov (United States)

    Jordan, Jens; Heusser, Karsten; Brinkmann, Julia; Tank, Jens

    2012-12-24

    Treatment resistant arterial hypertension is commonly defined as blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes. The sympathetic nervous system promotes arterial hypertension and cardiovascular as well as renal damage, thus, providing a logical treatment target in these patients. Recent physiological studies suggest that baroreflex mechanisms contribute to long-term control of sympathetic activity and blood pressure providing an impetus for the development of electrical carotid sinus stimulators. The concept behind electrical stimulation of baroreceptors or baroreflex afferent nerves is that the stimulus is sensed by the brain as blood pressure increase. Then, baroreflex efferent structures are adjusted to counteract the perceived blood pressure increase. Electrical stimulators directly activating afferent baroreflex nerves were developed years earlier but failed for technical reasons. Recently, a novel implantable device was developed that produces an electrical field stimulation of the carotid sinus wall. Carefully conducted experiments in dogs provided important insight in mechanisms mediating the depressor response to electrical carotid sinus stimulation. Moreover, these studies showed that the treatment success may depend on the underlying pathophysiology of the hypertension. Clinical studies suggest that electrical carotid sinus stimulation attenuates sympathetic activation of vasculature, heart, and kidney while augmenting cardiac vagal regulation, thus lowering blood pressure. Yet, not all patients respond to treatment. Additional clinical trials are required. Patients equipped with an electrical carotid sinus stimulator provide a unique opportunity gaining insight in human baroreflex physiology.

  3. Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis

    Institute of Scientific and Technical Information of China (English)

    LUO Rong-jiang; LIU Shao-rui; LI Xiao-min; ZHUO Ye-hong; TIAN Zhen

    2010-01-01

    Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis.Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors,by comparing the two groups.Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome.Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.

  4. Surgical management of unruptured posterior carotid artery wall aneurysms.

    Science.gov (United States)

    O'Shaughnessy, Brian A; Getch, Christopher C; Bendok, Bernard R; Batjer, H Hunt

    2003-07-15

    Intracranial aneurysms arising from the posterior wall of the supraclinoid carotid artery are extremely common lesions. The aneurysm dilation typically occurs in immediate proximity to the origin of the posterior communicating artery and, less commonly, the anterior choroidal artery (AChA). Because of the increasingly widespread use of noninvasive neuroimaging methods to evaluate patients believed to harbor cerebral lesions, many of these carotid artery aneurysms are now documented in their unruptured state, prior to occurrence of subarachnoid hemorrhage. Based on these factors, the management of unruptured posterior carotid artery (PCA) wall aneurysms is an important element of any neurosurgical practice. Despite impressive recent advances in endovascular therapy, the placement of microsurgical clips to exclude aneurysms with preservation of all afferent and efferent vasculature remains the most efficacious and durable therapy. To date, an optimal outcome is only achieved when the neurosurgeon is able to combine systematic preoperative neurovascular assessment with meticulous operative technique. In this report, the authors review their surgical approach to PCA wall aneurysms, which is greatly based on the extensive neurovascular experience of the senior author. Focus is placed on their methods of preoperative evaluation and operative technique, with emphasis on neurovascular anatomy and the significance of oculomotor nerve compression. They conclude by discussing surgery-related complications, with a particular focus on intraoperative rupture of aneurysms and their management, and the postoperative ischemic AChA syndrome.

  5. CrossFit-related cervical internal carotid artery dissection.

    Science.gov (United States)

    Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

    2015-08-01

    CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients.

  6. [Revascularization of the carotid and vertebral arteries in the elderly].

    Science.gov (United States)

    Illuminati, G; Bezzi, M; D'Urso, A; Giacobbi, D; Ceccanei, G; Vietri, F

    2004-01-01

    From January 1994 to July 2004, 323 patients underwent 348 revascularization of carotid bifurcation for atherosclerotic stenoses. Eighty eight patients (group A) were 75 year-old or older, whereas 235 (group B) were younger than 75 years. Postoperative mortality/neurologic morbidity rate was 1% in group A, and 1.4% in group B. At 5 years, patency and freedom from symptoms/stroke were, respectively, 91% and 92% in group A, and 89% and 91% in group B. None of these differences was statistically significant. In the same time period, 26 internal carotid arteries were revascularized in 24 patients, 75 or more aged, for a symptomatic kinking. Postoperative mortality/morbidity rate was absent, whereas, at 5 years, patency and freedom from symptoms/stroke were, respectively, 88% and 92%. Twelve vertebral arteries were revascularized in 12 patients, 75 or more aged, for invalidating symptoms of vertebrobasilar insufficiency. Postoperative mortality/neurologic morbidity rate was absent. In one case postoperative recurrence of symptoms occurred, despite a patent revascularization. Patency and freedom from symptoms/stroke were 84% and 75%, at 5 years. Revascularization of carotid and vertebral arteries in the elderly can be accomplished with good results, superposable to those of standard revascularization of carotid bifurcation in a younger patients' population.

  7. Follow up of intima-media thickness after severe early-onset preeclampsia

    NARCIS (Netherlands)

    Blaauw, Judith; Souwer, Esteban T D; Coffeng, Sophie M; Smit, Andries J; van Doormaal, Jasper J; Faas, Marijke M; van Pampus, Maria G

    2014-01-01

    OBJECTIVE: Early-onset preeclampsia is associated with premature cardiovascular disease. We previously demonstrated that femoral intima-media thickness (IMT) and markers of cardiovascular disease were increased in women 1 year after early-onset preeclampsia. The current study measured (progression o

  8. A suggested training programme for carotid artery stenting (CAS)

    Energy Technology Data Exchange (ETDEWEB)

    Gaines, Peter [Sheffield Vascular Institute, Northern General Hospital, Sheffield S5 7AU (United Kingdom)]. E-mail: P.A.gaines@Sheffield.ac.uk; Nicholson, Tony [Leeds Teaching Hospitals NHS Trust, Great George St., Leeds LS13EX (United Kingdom)]. E-mail: tonynick@tonynick.karoo.co.uk

    2006-10-15

    Carotid artery stenting as an alternative to traditional carotid endartrectomy is becoming increasingly important in the treatment of transient ischemic attack and stroke. Physicians from several different medical disciplines are interested in treating appropriate patients by this method. Patients are entitled to know what training and experience the surgeon or clinician has before giving consent. This should involve endovascular experience in all systems and experience and knowledge of cerebral angiography and intervention. A multidisciplinary approach and reporting of adverse events is vital for patient safety.

  9. Prevalence of significant carotid artery stenosis in patients with transient ischaemic attack

    DEFF Research Database (Denmark)

    Rappeport, Yael; Simonsen, Lene; Christiansen, Hanne Hjertmann;

    2002-01-01

    Carotid artery stenosis is one of the risk factors for transient ischaemic attack (TIA) and stroke. The purpose of this study was to investigate the prevalence of carotid artery stenosis and the prevalence of candidates for carotid endarterectomy in a hospital-based cohort of TIA patients under 71...

  10. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children.

    Science.gov (United States)

    Iannuzzi, Arcangelo; Licenziati, Maria Rosaria; Vacca, Maria; De Marco, Donata; Cinquegrana, Giorgio; Laccetti, Marco; Bresciani, Alessandro; Covetti, Giuseppe; Iannuzzo, Gabriella; Rubba, Paolo; Parillo, Mario

    2009-11-01

    Childhood obesity is associated with an increased carotid intima-media thickness (IMT) and stiffness. Increased carotid wall thickening and rigidity are considered markers of subclinical atherosclerosis. The aim of the present study was to test the effect of two hypocaloric diets of varying glycemic index on weight loss and markers of subclinical atherosclerosis in obese children. Seventy consecutive obese children attending the Outpatient Weight Clinic of the Department of Pediatrics were invited to participate in an intensive dietary protocol. Twenty-six accepted and were randomly assigned to two different groups: the first group followed a hypocaloric low-glycemic index diet and the second a hypocaloric high-glycemic index diet. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness (IMT) and diameters of the common carotid artery. Considering both groups together, at 6 months, body mass index decreased from 28.3 +/- 3.1 to 25.8 +/- 3.3 kg/m(2), systolic blood pressure from 119 +/- 12 to 110 +/- 11 mmHg (Pglycemic index diet. These results justify the advice to obese children to follow a low-glycemic index diet in order to improve their cardiometabolic profile.

  11. Surgical techniques and curative effect of carotid endarterectomy for carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Min HAN

    2014-02-01

    Full Text Available Objective To investigate the surgical techniques of carotid endarterectomy (CEA for treating carotid artery stenosis, in order to improve the surgical efficacy and reduce intraoperative adverse events and complications after operation. Methods Retrospective analysis was carried out on surgical data of 53 cases who were performed CEA from October 2010 to October 2013 in Department of Neurosurgery in Tianjin Huanhu Hospital. There were 39 males and 14 females, aged from 40 to 78 years old and mean age (60.34 ± 8.92 years old; the course of disease was from 2 d to 4 years. Twenty-six cases were diagnosed as right carotid stenosis, 15 cases left carotid stenosis and 12 cases double-sided carotid stenosis. Among all of those cases, 35 cases were diagnosed as moderate stenosis (30%-69%, 16 cases severe stenosis (70%-99% , and 2 cases complete occlusion. Results Among 53 patients, 50 patients underwent CEA; 2 cases underwent CEA and aneurysm clipping; one case underwent stent removal surgery and CEA because restenosis was found after carotid artery stenting (CAS. Postoperative neck CTA and fMRI showed good morphology of carotid artery, fluent blood flow and improved cerebral perfusion after operation. All of those patients were followed up for 3 to 24 months. One case died of myocardial infarction; 2 cases appeared skin numbness on the operating side of the neck, and the symptom disappeared 3 months later; one case appeared hoarseness after operation; 3 cases experienced mild transient ischemic attack (TIA and the symptom disappeared 2 months later. No case of stroke was found. Conclusions CEA is a safe and effective surgical approach to treat carotid stenosis. Correct and reasonable choices of the surgical indications and skilled surgical technique are the key to ensure the success of operation and to improve efficacy of the therapy. doi:10.3969/j.issn.1672-6731.2014.02.006Video: http://www.cjcnn.org/index.php/cjcnn/pages/view/v14n2a6

  12. [Internal carotid artery dissection after Heimlich maneuver].

    Science.gov (United States)

    Rakotoharinandrasana, H; Petit, E; Dumas, P; Vandermarcq, P; Gil, R; Neau, J-Ph

    2003-01-01

    We report a case of cervical artery dissection following a Heimlich maneuver. Cervical artery dissections are at the present time well known and are sometimes associated with trivial traumas. However, to our knowledge, this complication of such maneuver was never reported in the literature. Pathophysiological mechanisms are discussed.

  13. Management of a chronic carotid artery pseudoaneurysm.

    Science.gov (United States)

    Baker, Aaron C; Arko, Frank R; Zarins, Christopher K; Lee, Eugene S

    2010-01-01

    An 82-year-old female with a history of right carotid endarterectomy with patch closure 12 years prior presents with a pulsatile right neck mass with skin erosion and bleeding. The patient had been previously evaluated but refused the surgical intervention because a median sternotomy was recommended to obtain adequate proximal control. Her aneurysm was successfully repaired using a combination of open and endovascular method. The repair was performed through a right-hand side anterior sternocleidomastoid neck incision, and proximal vascular control was obtained with an 8.5-mm balloon positioned under fluoroscopic guidance via a femoral puncture.

  14. Ultrasound Common Carotid Artery Segmentation Based on Active Shape Model

    Directory of Open Access Journals (Sweden)

    Xin Yang

    2013-01-01

    Full Text Available Carotid atherosclerosis is a major reason of stroke, a leading cause of death and disability. In this paper, a segmentation method based on Active Shape Model (ASM is developed and evaluated to outline common carotid artery (CCA for carotid atherosclerosis computer-aided evaluation and diagnosis. The proposed method is used to segment both media-adventitia-boundary (MAB and lumen-intima-boundary (LIB on transverse views slices from three-dimensional ultrasound (3D US images. The data set consists of sixty-eight, 17 × 2 × 2, 3D US volume data acquired from the left and right carotid arteries of seventeen patients (eight treated with 80 mg atorvastatin and nine with placebo, who had carotid stenosis of 60% or more, at baseline and after three months of treatment. Manually outlined boundaries by expert are adopted as the ground truth for evaluation. For the MAB and LIB segmentations, respectively, the algorithm yielded Dice Similarity Coefficient (DSC of 94.4% ± 3.2% and 92.8% ± 3.3%, mean absolute distances (MAD of 0.26 ± 0.18 mm and 0.33 ± 0.21 mm, and maximum absolute distances (MAXD of 0.75 ± 0.46 mm and 0.84 ± 0.39 mm. It took 4.3 ± 0.5 mins to segment single 3D US images, while it took 11.7 ± 1.2 mins for manual segmentation. The method would promote the translation of carotid 3D US to clinical care for the monitoring of the atherosclerotic disease progression and regression.

  15. Skin autofluorescence is increased in patients with carotid artery stenosis and peripheral artery disease

    NARCIS (Netherlands)

    Noordzij, Marjon J.; Lefrandt, Joop D.; Loeffen, Erik A. H.; Saleem, Ben R.; Meerwaldt, Robbert; Lutgers, Helen L.; Smit, Andries J.; Zeebregts, Clark J.

    2012-01-01

    Advanced glycation end products (AGEs) have a pivotal role in atherosclerosis. We evaluated skin autofluorescence (SAF), a non-invasive measurement of tissue AGE accumulation, in patients with carotid artery stenosis with and without coexisting peripheral artery occlusive disease (PAOD). SAF was mea

  16. Computational modeling of hypertensive growth in the human carotid artery

    Science.gov (United States)

    Sáez, Pablo; Peña, Estefania; Martínez, Miguel Angel; Kuhl, Ellen

    2014-06-01

    Arterial hypertension is a chronic medical condition associated with an elevated blood pressure. Chronic arterial hypertension initiates a series of events, which are known to collectively initiate arterial wall thickening. However, the correlation between macrostructural mechanical loading, microstructural cellular changes, and macrostructural adaptation remains unclear. Here, we present a microstructurally motivated computational model for chronic arterial hypertension through smooth muscle cell growth. To model growth, we adopt a classical concept based on the multiplicative decomposition of the deformation gradient into an elastic part and a growth part. Motivated by clinical observations, we assume that the driving force for growth is the stretch sensed by the smooth muscle cells. We embed our model into a finite element framework, where growth is stored locally as an internal variable. First, to demonstrate the features of our model, we investigate the effects of hypertensive growth in a real human carotid artery. Our results agree nicely with experimental data reported in the literature both qualitatively and quantitatively.

  17. Acute Carotid Artery Stent Thrombosis Due to Dual Antiplatelet Resistance

    Energy Technology Data Exchange (ETDEWEB)

    Köklü, Erkan, E-mail: drerkankoklu@gmail.com; Arslan, Şakir; Yüksel, İsa Öner; Bayar, Nermin [Antalya Education and Research Hospital, Clinic of Cardiology (Turkey); Koç, Pınar [Antalya Education and Research Hospital, Clinic of Radiology (Turkey)

    2015-08-15

    Carotid artery stenting (CAS) is a revascularization modality that is an alternative to carotid endarterectomy. The efficacy of CAS in primary and secondary prevention from ischemic stroke has been demonstrated in various trials. Acute thrombosis of CAS is a rare complication that can lead to dramatic and catastrophic consequences. We discuss a case of acute CAS thrombosis in a patient who had previously undergone successful CAS. CAS was performed in a 73-year-old man who had had dysarthria lasting 2 weeks with 95 % stenosis in his left internal carotid artery. An acute cerebrovascular event resulting in right-sided hemiplegia developed 24 h after the procedure. Computed tomographic carotid angiography revealed complete occlusion of the stent with thrombus. The cause of stent thrombosis was thought to be antiaggregant resistance to both acetylsalicylic acid and clopidogrel. The most important cause of acute CAS thrombosis is inadequate or ineffective antiaggregant therapy. Evaluating patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may preclude this complication.

  18. Carotid stenting through the right brachial approach for left internal carotid artery stenosis and bovine aortic arch configuration

    Energy Technology Data Exchange (ETDEWEB)

    Montorsi, Piero; Galli, Stefano; Ravagnani, Paolo; Ghulam Ali, Sarah; Trabattoni, Daniela; Fabbiocchi, Franco; Lualdi, Alessandro; Ballerini, Giovanni; Andreini, Daniele; Pontone, Gianluca; Annoni, Andrea; Bartorelli, Antonio L. [Institute of Cardiology University of Milan, Centro Cardiologico Monzino, IRCCS, Milan (Italy)

    2009-08-15

    Unfavorable complex anatomy or congenital anomalies of supra-aortic vessel take-off may increase carotid artery stenting (CAS) procedural difficulties and complications through the femoral route. We assessed the feasibility, safety, and efficacy of CAS through the right brachial approach in patients in whom left internal carotid artery stenosis and bovine aortic arch configuration were identified with computed tomography (CT) angiography. Bovine configuration of the aortic arch and left carotid artery stenosis were easily identified by CT angiography and successfully treated through the right brachial approach technique. (orig.)

  19. [Analysis of the timing parameters of blood flow in the carotid basin arteries of hypertensive patients].

    Science.gov (United States)

    Makarenko, E S

    2011-01-01

    Vascular duplex ultrasound study with simultaneous ECG recording was performed to estimate the timing parameters of blood flow in the common carotid, internal carotid, and middle cerebral arteries in patients with grades 1 and 2 arterial hypertension. There was an increase in the blood flow acceleration phase index in the common carotid and middle cerebral arteries and a reduction in the systolic phase index in the internal carotid arteries. There were correlations of phasic blood flow parameters in the extra- and intracranial arteries with age and lipidogram readings.

  20. Effect of rosuvastatin on inflammatory factors and carotid atherosclerotic plaque in patients with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    YAN Jun

    2013-10-01

    Full Text Available Carotid atherosclerosis is closely related with ischemic stroke occurrence, development and recurrence. This study aims to make an evaluation of the effects of rosuvastatin on inflammatory factors, serum lipid and carotid atherosclerotic plaque in patients with acute ischemic stroke. In this study, 98 patients with acute ischemic stroke and carotid atherosclerosis were given oral administration of rosuvastatin calcium (10 mg once every night, and the course of treatment was 6 months. After treatment, the changes of serum high-sensitivity C-reactive protein (hs-CRP, tumor necrosis factor-alpha (TNF-α and blood lipid were measured, as well as carotid atherosclerotic intima-media thickness (IMT and the calculation of carotid atherosclerotic plaque score. According to the examination results, after 6 months' treatment with rosuvastatin, serum hs-CRP, TNF-α, total cholesterol (TC, triglyceride (TG and low-density lipoprotein cholestrol (LDL-C decreased significantly (P < 0.01, for all, while high-density lipoprotein cholestrol (HDL-C increased significantly (P < 0.01; the total number of plaque reduced, while the number of stable plaque increased (P < 0.05; carotid artery IMT and carotid artery plaque score decreased significantly (P < 0.05. There were significant differences between before and after treatment. The results of this study show that rosuvastatin plays a role in anti-inflammation and alleviates the degree of carotid atherosclerotic plaque.

  1. Blood pressure-independent hypotrophy of the heart, kidneys and conduit arteries after 7-nitroindazole administration to Wistar rats from the prenatal period to adulthood.

    Science.gov (United States)

    Kristek, F; Malekova, M; Ondrias, K; Cacanyiova, S

    2013-02-01

    The aim of this study was to investigate the long-term effects of 7-nitroindazole on the heart, kidneys, thoracic aorta, and carotid arteries from the progeny of mothers that had been treated with 7-nitroindazole (7NI) (10 mg/kg/day in drinking water) during gestation and nursing. The offspring were also treated with 7NI (10 mg/kg/day in drinking water) until 10 weeks of age. Mean arterial pressure (BP) was measured by tail-cuff plethysmography starting at 4 weeks of age. After perfusion fixation with glutaraldehyde at 120 mmHg, the heart and kidneys were weighed and the thoracic aorta and carotid arteries were processed for morphological investigation. The BP and body weight of treated rats did not differ from age-matched control rats during the course of the experiment. In the experimental group, at the end of the experiment, the heart weight/body weight and kidney weight/body weight ratios were decreased. In addition, the wall thickness (intima + media), cross sectional area (intima + media), and wall thickness/inner diameter ratio were significantly decreased in both the thoracic aorta and carotid arteries without a change in the inner vessel diameter. Circumferential wall tension was increased in both arteries. The data clearly indicate that long-term inhibition of neuronal nitric oxide (NO) synthase with the specific inhibitor 7NI evokes BP-independent hypotrophy of the heart, kidneys, and conduit arterial walls in normotensive Wistar rats.

  2. Bilateral Internal Carotid Artery Occlusion Associated with the Antiphospholipid Antibody Syndrome

    Directory of Open Access Journals (Sweden)

    Pria Anand

    2014-03-01

    Full Text Available A 39-year-old woman presented with a right-hemispheric stroke 1 year after she had suffered a left-hemispheric stroke. Her diagnostic workup was notable for bilateral occlusions of the internal carotid arteries at their origins and a positive lupus anticoagulant antibody test. There was no evidence of carotid dissection or another identifiable cause for her carotid occlusions. These findings suggest that the antiphospholipid antibody syndrome may be implicated in the pathological changes that resulted in occlusions of the extracranial internal carotid arteries. Young stroke patients who present with unexplained internal carotid artery occlusions may benefit from testing for the presence of antiphospholipid antibodies.

  3. Bilateral internal carotid artery occlusion associated with the antiphospholipid antibody syndrome.

    Science.gov (United States)

    Anand, Pria; Mann, Sharan K; Fischbein, Nancy J; Lansberg, Maarten G

    2014-01-01

    A 39-year-old woman presented with a right-hemispheric stroke 1 year after she had suffered a left-hemispheric stroke. Her diagnostic workup was notable for bilateral occlusions of the internal carotid arteries at their origins and a positive lupus anticoagulant antibody test. There was no evidence of carotid dissection or another identifiable cause for her carotid occlusions. These findings suggest that the antiphospholipid antibody syndrome may be implicated in the pathological changes that resulted in occlusions of the extracranial internal carotid arteries. Young stroke patients who present with unexplained internal carotid artery occlusions may benefit from testing for the presence of antiphospholipid antibodies.

  4. Breast arterial calcification on mammogram: correlation with carotid arterial atherosclerosis on ultrasonogram

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Ju; Suh, Jung Ho [School of Medicine, Ajou Univ., Suwon (Korea, Republic of); Kim, Ji Hyung [College of Medicine, KonYang Univ., Nonsan (Korea, Republic of)

    2002-01-01

    To investigate the incidence of breast arterial calcification in Korean women, and to determine its association with systemic diseases and carotid arterial atherosclerosis. One thousand seven hundred and thirteen female subjects who underwent mammography at a health care center between May 1999 and May 2000 were included in this study. Of the total, 172 were found to have breast arterial calcification, and were classified according to age. The coincidence of hypertension, diabetes mellitus and hyperlipidemia was examined in both the subject group and the control group selected on the same age basis. To investigate the presence and degree of carotid atherosclerosis, sonographic imaging was performed and the findings were compared between the two groups. The incidence of breast arterial calcification showed statistically significant differences according to age, with a higher incidence in older patients (p<0.05). However, there was no statistical difference in the incidence of hypertension, hyperlipidemia, and diabetes mellitus between groups. Carotid atherosclerosis was subjects more prevalent among subjects than in the control group (p<0.05), though there was no statistically significant difference in the degree of luminal stenosis. The most common pathologic cause of breast arterial calcification is arteriosclerosis. Breast arterial calcification is demonstrated at mammography, along with other clinical risk factors for atherosclerosis or coincidental neurologic symptoms. We stress that further evaluation of the carotid artery is necessary.

  5. Diagnosis of carotid artery atheroma by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Katsuhiro; Watanabe, Shigeru; Daimon, Yumiko; Sakurada, Hideki; Urano, Miharu; Sun, Kezhu; Hijikata, Yasuyoshi; Inoue, Toshihisa; Masuda, Yoshiaki [Chiba Univ. (Japan). School of Medicine

    2001-03-01

    Atheroma appears as a very low signal intensity area on 2-dimensional time-of-flight (TOF) magnetic resonance (MR) images, and its components have various signal intensities on spin-echo (SE) images. The present study investigated atheroma of the carotid arteries in 37 subjects with risk factors (63{+-}10 years of age; 19 men) by magnetic resonance imaging (MRI). On 2-dimensional (2D) TOF images, the carotid arteries were clearly demonstrated in all cases and atheroma was detected in 23 patients. The most common location of atheroma was at the origin of the internal carotid artery. There was vascular remodeling in all patients with atheroma. 2D-TOF images showed 97% agreement with ultrasonography. SE images clearly demonstrated atheroma in all 23 patients with atheroma. All patients with atheroma showing high signal intensity on T1-weighted images had hyperlipidemia. These findings indicate that the 2D-TOF imaging method is useful for detecting atheroma and SE-images are useful for its characterization. (author)

  6. Conjunctival-corneal melt in association with carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Rosalind MK Stewart

    2008-10-01

    Full Text Available Rosalind MK Stewart1, Say Aun Quah1, Dan Q Nguyen2, Stephen B Kaye11Royal Liverpool University Hospital, Liverpool, UK; 2Bristol Eye Hospital, Bristol, UKPurpose: To report a case of severe conjunctival-corneal melt in association with carotid artery stenosis.Methods: Observational case report.Results: A 76-year-old man with a history of bilateral severe carotid artery occlusion and nonarteritic ischemic optic neuropathy developed a spontaneous bulbar conjunctival defect. Despite intensive lubrication, and attempts at surgical closure including an amniotic membrane patch graft, it progressed with subsequent adjacent corneal perforation. Thorough investigations revealed no underlying disease, except markedly delayed episcleral vessel filling on anterior segment fluorescein angiography.Conclusions: Neovascularisation is a known factor in the inhibition of ulceration. In light of the findings in this report, ocular ischemia should be considered as a cause or contributing factor in the differential diagnosis of conjunctival-corneal melt.Keywords: conjunctival melt, corneal melt, ocular ischemia, carotid artery stenosis

  7. Reconstruction of Injured Carotid Artery in a Comatose Patient

    Directory of Open Access Journals (Sweden)

    Arben Zenelaj

    2014-06-01

    Full Text Available A man 30 years old,was brought to the emergency department after being injured on the left side of the neck area.Massive bleeding from the wound caused by glass was observed.The patient was in cerebral coma and hemorrahagic shock.The eye pupils remained isochoric during and after the operation.He was taken immediately at the surgery room.The bleeding was stopped by using external compression.Exposure of the left neck blood vessels was carried out.The left common carotid artery and internal jugular vein was revealed.A provisory Pruitt-Inahara shunt was put in the common carotid artery,while teh injured vein was ligated.The suture of the left common carotid artery using Prolen 6-0 completed the procedure.After the surgery the patient was transferred to the intensive care unit.About two hours later he woke up,conscious.The left thoracic drainage because of the hemothorax was applied in the second postoperative day.The patient was lively and discharged from the hospitall in the 14-th postoperative day.The right facial paresis and mild left side hemiparesis persisted.Two months after the event no residual neurologic deficits were observed. [Cukurova Med J 2014; 39(3.000: 598-601

  8. [Egas Moniz and the obstructions of the internal carotid artery].

    Science.gov (United States)

    da Gama, A Dinis

    2004-01-01

    Claude Miller Fisher is quoted as the discoverer of the pathogenic relationship between the carotid artery occlusive disease and cerebral ischemia, through his work published in 1951, where he describes the cerebral consequences arising from the internal carotid artery occlusion and, later on, the diverse clinical manifestations that it can cause (TIA's and CVA's). However, 20 years before, Egas Moniz, following the research work which lead to the discovery of cerebral angiography, had already mentioned and demonstrated such relationship, and published their observations in the portuguese, spanish and french medical literatures. As he did not published his works in the english literature, he did not get credit nor recognition on the fact, that was later developed by Miller Fisher who dedicated extensive contribution and divulgation on the subject. The present paper is dedicated to an historical review of the pionier work of Egas Moniz and co-workers, aimed to a better understanding of the pathogenic relationship between internal carotid artery occlusions and cerebral ischemia.

  9. The atherosclerosis burden score (ABS): a convenient ultrasound-based score of peripheral atherosclerosis for coronary artery disease prediction.

    Science.gov (United States)

    Yerly, Patrick; Marquès-Vidal, Pedro; Owlya, Reza; Eeckhout, Eric; Kappenberger, Lukas; Darioli, Roger; Depairon, Michèle

    2015-03-01

    Ultrasonographic detection of subclinical atherosclerosis improves cardiovascular risk stratification, but uncertainty persists about the most discriminative method to apply. In this study, we found that the "atherosclerosis burden score (ABS)", a novel straightforward ultrasonographic score that sums the number of carotid and femoral arterial bifurcations with plaques, significantly outperformed common carotid intima-media thickness, carotid mean/maximal thickness, and carotid/femoral plaque scores for the detection of coronary artery disease (CAD) (receiver operating characteristic (ROC) curve area under the curve (AUC) = 0.79; P = 0.027 to ABS was also more correlated with CAD extension (R = 0.55; P ABS was weakly correlated with the European Society of Cardiology chart risk categories (R(2) = 0.21), indicating that ABS provided information beyond usual cardiovascular risk factor-based risk stratification. Pending prospective studies on hard cardiovascular endpoints, ABS appears as a promising tool in primary prevention.

  10. Ultrasonography for Carotid intima-media thickness in aged patients with diabetes and analysis of risk factors%老年糖尿病患者颈动脉内-中膜检测及斑块形成相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    莎仁高娃; 姜颖; 楼慧萍

    2009-01-01

    目的 应用彩色多普勒超声技术研究2型糖尿病老年患者颈动脉粥样硬化(AS)特点及其相关危险因素.方法 对111例糖尿病老年患者双侧颈动脉检测结果与对照组97例健康人群进行比较;将糖尿病病组分为斑块组及非斑块组,分析斑块形成的相关危险因素.结果 糖尿病组颈动脉内中膜厚度明显高于对照组(P0.05).糖尿病班块组与非斑块组比较,餐后2 h血糖、高脂血症病程、高血压痛程、高密度脂蛋白(HDL),及糖尿病并发症差异具有统计学意义(P0.05).There were statistical difference in the results of 2 hour postprandial glucose,course of the hypedipoidemia and hypertension,hish density fipoproteins-cholesterol and diabetic complication between phque and no -plaque group.Conclusion It was a main feature that thickened IMT and formed carotid atherosclerotic plaques in the aged patients with tape 2 diabetes.Some factors were direct risks for carotid plaque.

  11. THE LATENT INTERCONNECTION OF THE FACTORS OF ATHEROSCLEROSIS PROGRESSION WITH A THICKNESS OF INTIMA-MEDIA BY USE OF MULTIDIMENSIONAL STATISTICAL METHODS ANALYSIS

    Directory of Open Access Journals (Sweden)

    A. P. Shavrin

    2011-01-01

    Full Text Available The aim – the study of latent relationships between indicators of the thickness of intima-media (CMM and infectious, immune, inflammatory and metabolic factors in patients with varying degrees of severity of vascular changes in these multivariate methods of statistical analysis.Materials and methods. Study included 220 patients (mean age – 43,9 ± 0,5 years who were divided into 3 groups. Group 1 consisted of thepatients with no risk factors of cardiovascular disease (CVD, the 2nd – the presence of the above factors, in third – with atherosclerotic plaques in the carotid artery. Every patient had conducted a comprehensive survey, which included an ultrasound of vessels on the apparatus Aloka 5000 with the measurement of the thickness of KIM, the study of lipid panel, the definition of C-reactive protein and cytokines – tumor necrosis factor-α, interferon-γ, interleukin-1, -8, -4, antibodies to cytomegalovirus immunoglobulin (CMV, herpes simplex virus type 1, C. pneumoniae, H. pylori and β-hemolytic streptococcus group A. The immune system status was assessed by indicators of innate and acquired immunity.Results. According to cluster analysis, all groups of patients revealed the presence of close relationships with linear thickness KIM, infectious, immune and metabolic markers, and in patients with atherosclerotic plaques in blood vessels links with indicators of inflammation are additionally found. Using factor analysis latent variables exist revealed, consisting of indices and thickness of the CMM, in group 1 – blood lipids, in the 2nd – infectious factors (CMV, C. pneumoniae and immune parameters. In the 3rd group vascular wall was linked with infectious diseases, immune and inflammatory indices and blood lipids, and systolic and diastolic blood pressure.Conclusion. The closest relationship with vascular wall of the studied parameters was observed in patients with risk factors of cardiovasculardisease, and in the

  12. The effect of lipid regulation with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction

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    Shu XU

    2015-11-01

    Full Text Available Objective To analyze the effect of intensive lipid regulation treatment with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction.  Methods Ninety-two patients with atherosclerotic cerebral infarction were randomly divided into two groups: observation group (treated by atorvastatin calcium with the dosage of 20 mg/d, N = 46 and control group (treated by diet without lipid-rich food, N=46. Besides, other drugs given to the patients in two groups were the same. The blood lipid levels and the changes of carotid artery plaques in two groups were analyzed and compared before treatment and 3 months after treatment. Results After treatment, the concentrations of total cholesterol [TC, (4.23 ± 0.92 mmol/L vs (5.24 ± 0.68 mmol/L], triglyceride [TG, (2.46 ± 0.28 mmol/L vs (3.33 ± 0.47 mmol/L], low-density lipoprotein cholesterol [LDL-C, (2.52 ± 0.38 mmol/L vs (4.78 ± 0.86 mmol/L] in the patients of observation group were all decreased and significantly lower than those in the control group (P = 0.000, for all, and the concentration of high-density lipoprotein cholesterol [HDL-C, (1.13 ± 0.41 mmol/L vs (0.85 ± 0.32 mmol/L] in the patients of observation group was increased and significantly than that in the control group (P = 0.003. The carotid artery plaque size [(20.25 ± 0.32 mm2 vs (24.42 ± 10.33 mm2] and thickness [(0.59 ± 0.13 mm vs (1.93 ± 0.23 mm] of carotid artery plaques and intima?media thickness [IMT, (1.32 ± 0.67 mm vs (1.63 ± 0.56 mm] of common carotid artery (CCA in the patients of observation group were all significantly lower than those in patients in the control group (P = 0.000, 0.000, 0.010, respectively. Comparing serum alanine aminotransferase (ALT, aspartate aminotransferase (AST, creatine kinase (CK and creatinine (Cr levels after treatment with before treatment, there was no significant difference between 2 groups (P > 0.05, for all.  Conclusions

  13. Studies on carotid artery atherosclerosis and its related factors in maintenance hemodialysis patients%维持性血液透析患者颈动脉粥样硬化及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    郭美华; 皮小陵; 徐琴芳; 傅立倩

    2012-01-01

    Objective To understand the formation of carotid artery atherosclerosis (CAS) and its potential causes in maintenance hemodialysis {MHD) patients. Methods We recruited 55 MHD cases and measured their physical dimensions of bilateral carotid arteries by using high resolution ultrasonography. They were then assigned into plaque positive group or plaque negative group. Data were compared between the two groups. Logistic regression analysis was performed to disclose the potential factors leading to plaque generation. Results Atherosclerotic plaque was found in 69.09% of the 55 MHD cases. The intima-media thickness (IMT) of the carotid arteries was significant larger in plaque positive group than in negative group (P=0,001). Other significant differences between the two groups included age (P=0.000), hemoglobin (Hb) level (P=0.01) and C reactive protein (CRP) level (P=0.002). Logistic regression analysis indicated that older age 0=1.102, P=0.014) and higher CRP level (β=0.138, P=0.026) were the two major contribution factors for atherosclerotic plaque formation. Conclusions MHD patients have higher potential of CAS. Older age and higher CRP level are the two major risk factors for atherosclerotic plaque formation in carotid artery.%目的 了解慢性肾衰竭维持性血液透析(maintenance hemodialysis,MHD)患者颈动脉粥样硬化(carotid artery atherosclerosis,CAS)发生情况并分析其相关影响因素. 方法 收集55例MHD患者.采用高分辨B型超声多普勒方法测定其双侧颈动脉解剖,按斑块有无分为斑块阳性组和斑块阴性组.对2组各数据进行比较,并对斑块产生的各危险因素进行Logistic回归分析.结果 55例MHD患者中,颈动脉斑块发生率为69.09%.与斑块阴性组相比,阳性组患者颈动脉血管内皮厚度(即内膜-中层厚度,intima-media thickness,IMT)明显增加(P=0.001).2组患者在年龄(P<0.001)、血红蛋白(hemoglobin,Hb)水平(P=0.01)和C反应蛋白(Creactive protein

  14. Prevalence of significant carotid artery stenosis in Iranian patients with peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Ghabili K

    2011-10-01

    Full Text Available Abolhassan Shakeri Bavil1, Kamyar Ghabili2, Seyed Ebrahim Daneshmand3, Masoud Nemati3, Moslem Shakeri Bavil4, Hossein Namdar5, Sheyda Shaafi61Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran; 4Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran; 5Department of Cardiology, Tabriz University of Medical Sciences, Tabriz, Iran; 6Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Generalized screening for carotid artery stenosis with carotid duplex ultrasonography in patients with peripheral arterial disease is controversial.Objectives: The aim of the present study was to determine the prevalence of significant internal carotid artery (ICA stenosis in a group of Iranian patients with peripheral arterial disease.Methods: We prospectively screened 120 patients with a known diagnosis of peripheral vascular disease for carotid artery stenosis. Based on the angiographic assessment of abdominal aorta and arteries of the lower extremities, patients with stenosis greater than 70% in the lower extremity arteries were included. A group of healthy individuals aged ≥50 years was recruited as a control. Risk factors for atherosclerosis including smoking, diabetes mellitus, hyperlipidemia, ischemic heart disease, and cerebrovascular disease were recorded. Common carotid arteries (CCAs and the origins of the internal and external arteries were scanned with B-mode ultrasonogaphy. Significant ICA stenosis, >70% ICA stenosis but less than near occlusion of the ICA, was diagnosed when the ICA/CCA peak systolic velocity ratio was ≥3.5.Results: Ninety-five patients, with a mean age of 58.52 ± 11.04 years, were studied. Twenty-five patients had a history of smoking, six

  15. Effect of treatment temperature on collagen structures of the decellularized carotid artery using high hydrostatic pressure.

    Science.gov (United States)

    Negishi, Jun; Funamoto, Seiichi; Kimura, Tsuyoshi; Nam, Kwangoo; Higami, Tetsuya; Kishida, Akio

    2011-09-01

    Decellularized tissues have attracted a great deal of attention as regenerating transplantation materials. A decellularizing method based on high hydrostatic pressure (HHP) has been developed, and the preparation of many types of decellularized tissues has been investigated, including aorta, cornea, and dermis. The preparation of a small-diameter vascular graft was studied using a carotid artery from the viewpoint of collagen denaturation and leakage. After HHP, the carotid artery was washed at two washing temperatures (37 and 4°C). Histological evaluation, collagen content measurement and circular dichroism (CD) measurement indicated that the washing temperatures clearly affected the collagen structure of the decellularized carotid artery. The amount of collagen decreased in the carotid artery decellularized by HHP washed at 37°C (HHP/37°C). On the other hand, the amount and structure of collagen were preserved in the carotid artery washed at 4°C after HHP (HHP/4°C). In rat carotid artery syngeneic transplantation, the HHP/37°C decellularized carotid artery occluded after 2 weeks, but the HHP/4°C decellularized one did not. These results indicate that collagen denaturation and leakage of the decellularized carotid artery affect the in vivo performance of the carotid artery.

  16. Importance of hemodynamic factors in vascular remodeling of muscular elastic type in arterial hypertension

    Directory of Open Access Journals (Sweden)

    Melnikova L.V.

    2011-03-01

    Full Text Available The research goal is to investigate the relationship between hemodynamic factors and parameters of remodeling of common carotid arteries. 102 patients with essential hypertension of l-ll stage (49 men, 53 women, average age 47,5±11,2 years, duration of hypertension 7,8±1,5 years have been examined. The study has revealed the relation between blood flow velocity in the common carotid artery (CCA and the parameters of vascular remodeling, depending on the degree of hypertension. With the increase in systolic blood pressure dilation of common carotid arteries has been observed, reducing the rate of blood flow and wall thickness of the intima-media complex, accompanied by increased stiffness of the vascular wall. The increase in systolic blood pressure is accompanied by decrease in the rate of blood flow and wall tension on the endothelium, which contributes to thickness of the intima-media complex and increases the rigidity of the vascular wall

  17. Lingual and facial arteries arising from the external carotid artery in a common trunk.

    Science.gov (United States)

    Troupis, Theodore G; Dimitroulis, Dimitrios; Paraschos, Alexandros; Michalinos, Adamantios; Protogerou, Vassilis; Vlasis, Konstantinos; Troupis, George; Skandalakis, Panayiotis

    2011-02-01

    The present study describes analytically a rare case in which lingual and facial arteries arise together from an external carotid artery in a common trunk. Thirty anatomic dissections were performed on 15 cadavers in the macroscopic laboratory in the Department of Anatomy of the Medical School of National and Kapodistrian University of Athens. One common trunk from which originated lingual and facial arteries was found. The frequency of this morphology is measured at 6 per cent. The length of the common trunk is measured at 7.3 mm between its origin and its diversion at the facial artery and lingual artery, its diameter at 2.8 mm, its distance from carotid bifurcation at 7.9 mm, and from the superior thyroid artery at 3.3 mm. At the left side of the neck region, facial and lingual arteries arose separately. The anatomic variations of the branching pattern of the external carotid artery and the micrometric values of the vessels are especially important as a result of the numerous operations performed in the neck region that implicate various specialties such as general surgery, head and neck surgery, plastic surgery, and maxillofacial surgery.

  18. Thermomechanical behavior of human carotid arteries in the passive state.

    Science.gov (United States)

    Guinea, G V; Atienza, J M; Elices, M; Aragoncillo, P; Hayashi, K

    2005-06-01

    Localized heating or cooling is expanding the clinical procedures used to treat cardiovascular diseases. Advantageous implementation and development of these methods are linked indissolubly to a deeper understanding of the arterial response to combined mechanical and thermal loads. Despite this, the basic thermomechanical behavior of human blood vessels still remains largely unknown, primarily due to the lack of appropriate experimental data. In this work, the influence of temperature on the passive behavior of human carotid arteries was studied in vitro by means of inflation tests. Eleven carotid segments were tested in the range 0-200 mmHg at four different temperatures of 17, 27, 37, and 42 degrees C. The results show that the combined change of temperature and stress has a dramatic effect on the dilatation coefficient of the arterial wall, which is shifted from negative to positive depending on the stress state, whereas the structural stiffness of the arterial wall does not change appreciably in the range of temperatures tested.

  19. Risk Factors of Flow-empty Area in Carotid Artery in Doppler Power Imaging%颈动脉多普勒能量图中出现流空区的危险因素

    Institute of Scientific and Technical Information of China (English)

    于冬; 刘吉良; 田东旭

    2015-01-01

    Purpose To explore the reason which resulted in the flow-empty area in carotid artery, establishing a logistic regression model of carotid artery by power Doppler ultrasound, screening the risk factors of the occurrence of this phenomenon and analyzing their reasons. Materials and Methods Clinical data of 172 male subjects who had undergone power Doppler ultrasound were analyzed retrospectively, whether there was flow-empty area at the edge of carotid artery lumen during diastole was observed, brachial artery systolic pressure, diastolic pressure and pressure difference, carotid artery intima media thickness, and the existence of atherosclerotic plaques was measured, the age, body mass index (BMI), blood glucose, blood lipid, history of smoking and cerebrovascular accident situation was collected to establish the logistic model to analyze the risk factors resulted in flow-empty area. Results Among the 172 patients, intima media thickened in 89 cases, systolic blood pressure increased in 97 cases, diastolic blood pressure increased in 7 cases, the pulse pressure increased in 90 cases, with the age of 65 years or older in 92 cases, atherosclerotic plaque formation in 84 cases, long smoking history in 63 cases, cerebral vascular accident history in 11 cases, diabetes mellitus in 79 cases, hyperlipidemia in 101 cases, and abnormal BMI in 13 cases. Doppler energy imaging showed flow-empty area wave type in 98 cases, no flow-empty area wave type in 74 cases. 5 statistically significant variables for the occurrence of flow-empty area in carotid artery lumen during diastole were selected using logistic regression, which were carotid artery intima media thickness, BASP, the pressure difference of brachial artery, existence of atherosclerotic plaque, and the age of patients (OR=50.643, 47.248, 29.426, 32.667 and 20.514, P<0.05). Conclusion The risk factors resulted in "flow-empty area" in carotid artery are increased IMT, systolic BP and pressure difference, existence of

  20. 痛风患者颈动脉内膜-中膜厚度与UA、CRP水平的关系探讨%RELATIONSHIP BETWEEN THE INTIMA-MEDIA THICKNESS OF CAROTID,BLOOD URIC ACID LEVEL AND C-REACTIVE PROTEIN IN PATIENTS WITH GOUT

    Institute of Scientific and Technical Information of China (English)

    欧阳清; 于健; 刘健; 陈辉; 周燕; 祖颖

    2011-01-01

    [目的]通过研究痛风患者颈动脉内膜-中膜厚度(IMT)与血尿酸(UA)、C 反应蛋白(CRP)的关系,研究 UA、CRP 在痛风患者动脉粥样硬化的作用.[方法]60 例痛风患者,正常对照组 40 例,分析 2 组人群空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血尿酸、C 反应蛋白,测定颈动脉内膜-中膜厚度,同时计算体重指数(BMI).[结果]痛风患者组与正常组比较:年龄、FPG、TG、HDL-C、BMI 无统计学差异(均P>0.05),UA、CRP、IMT 有统计学差异(P<0.01或P<0.05).痛风患者 IMT 与年龄、TC、TG、LDL-c、UA、BMI、CRP呈正相关(P<0.05或 P<0.01).[结论]UA、CRP 水平升高与痛风患者动脉粥样硬化(AS)关系密切,关注痛风患者 UA、CRP 水平的升高对临床具有重要意义.%[Objective] To investigate the relationship between the inlima-media thickness (IMT) of carotid, blood uric acid level (UA) and C-reactive protein (CRP) in patients with Gout, and to investigate UA and CRP affection on atheroscle rosis in those patients. [Methods] We collected 60 patients with Gout and 40 patients with the contral, measured fasting plas ma glucose (FPG), total cholesterol (TC), triglyceride (TG) , high density lipoprotein cholesterol (HDL-C) , low density lipoprotein cholesterol (LDL-C), UA and CRP in those two group patients, detected the IMT of carotid and calculated body mass index (BMI). [Results] The levels of UA, CRP and IMT in patients with Gout were significantly higher than those con trol subjects (P < 0.05 or P < 0.01). But the age, FPG, TG, HDL-C and BMI had no significantly difference in those two group patients (P> 0.05). The IMT had positively person correlation to age, TC, TG, LDL-C, UA, BMI and CRP (P<0.05 or P < 0.01) in the patients with gout. [Conclusion] The high levels of UA and CRP in blood were related to development pro gression of atherosclerotic disease in patients with Gout. It is

  1. HIV infection and arterial inflammation assessed by (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)

    DEFF Research Database (Denmark)

    Knudsen, Andreas; Hag, Anne Mette Fisker; Loft, Annika

    2015-01-01

    , the ascending, descending, and abdominal aorta. We performed correlation analyses between FDG uptake and intima-media thickness (IMT), and soluble biomarkers of inflammation. We found no difference in arterial FDG uptake between the HIV-infected patients and healthy controls quantified either as mean SUVmax...... or target-to background ratio in the carotid region, the ascending aorta, the descending aorta, or the abdominal aorta. Correlations between SUV, IMT, and soluble biomarkers were scarce in both groups. CONCLUSION: In a group of optimally treated HIV-infected patients with full viral suppression, low...

  2. Aberrant internal carotid artery in the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Keun Tak; Kang, Hyun Koo [Dept. of Radiology, Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2014-10-15

    The knowledge about the aberrant internal carotid artery (ICA) in the middle ear is essential for clinicians, because a misdiagnosis of the aberrant ICA could have serious consequences such as excessive aural bleeding during a middle ear surgery. A 38-year-old woman presented with tinnitus and hearing difficulties of the left ear that had started 5 years ago. During otoscopy, an anteroinferior bluish mass was seen in the tympanic space. Computed tomography and magnetic resonance imaging demonstrated a left-side aberrant ICA with bony dehiscence of the carotid canal in the middle ear and a reduced diameter of the tympanic ICA. Herein we report a case of an aberrant ICA in the middle ear. We also review the literature regarding this important vascular anomaly of the temporal bone which may lead to disastrous surgical complications.

  3. Carotid artery disease and low cerebral perfusion pressure

    DEFF Research Database (Denmark)

    Schroeder, T; Utzon, N P; Aabech, J

    1990-01-01

    Direct internal carotid artery blood pressure measurements in patients undergoing carotid endarterectomy identified 49 patients, among 239 consecutive cases (21%), who had a reduction in perfusion pressure of 20% or more. The clinical history, objective findings and angiographic data were compared...... with those of a control group of a further 49 patients selected from the remaining patients operated on over the same period. The two groups were compared for short- and long-term outcome of surgery. We were unable to delineate a symptomatic neurological profile that identified patients with low perfusion...... pressures. Surgery in patients with low perfusion pressures seemed to be associated with an increased complication rate (12% versus 4%), although this was not statistically significant. Definite postoperative improvements in persisting neurological deficits were observed only in one patient. Long...

  4. [Results of duplex scanning of brachiocephalic arteries and estimation of the lipid spectrum in coronary heart disease and arterial hypertension in indigenous and alien population of Yamalo-Nenetsky Autonomous District].

    Science.gov (United States)

    Gapon, L I; Sereda, T V; Leont'eva, A V; Gul'tiaeva, E P

    2013-01-01

    The work aimed at studying atherosclerotic lesions in brachiocephalic arteries and lipid spectrum in coronary heart disease (CHD) and arterial hypertension (AH) in indigenous and alien population of Yamalo-Nenetsky Autonomous District. It included 200 patients with CHD and AH (men and women aged 21-55 years, mean 48.2 +/- 07 yr). They were allocated to indigenous and alien groups (100 persons each). The patients matched for age and sex were examined by duplex scanning based at an outpatient facility (Salekhard). The indigenous population showed more pronounced thickening of the intima-media complex (IMC) of the common carotid artery (p = 0.001) and more frequent lesions of the main head arteries with stenosis of different severity (especially in internal carotid arteries). Total cholesterol, LDLP and atherogenicity index were similar in both groups and higher than normal. Indigenous subjects had less atherogenic structure of the lipid spectrum due to lower TG and VLDLP but higher HDLP levels.

  5. Arterial stiffness response to exercise in persons with and without Down syndrome.

    Science.gov (United States)

    Hu, Min; Yan, Huimin; Ranadive, Sushant M; Agiovlasitis, Stamatis; Fahs, Christopher A; Atiq, Muhammed; Atique, Nazia; Fernhall, Bo

    2013-10-01

    This study compared arterial stiffness and wave reflection at rest and following maximal exercise between individuals with and without Down syndrome (DS), and the influence of body mass index (BMI), peak oxygen uptake (VO2 peak) on changes in arterial stiffness. Twelve people with DS (26.6 ± 2.6 yr) and 15 healthy controls (26.2 ± 0.6 yr) completed this study. Intima-media thickness (IMT) and stiffness of common carotid artery was examined. Hemodynamic and arterial variables were measured before and 3-min after exercise. Persons with DS had higher BMI and lower VO 2 peak than controls. IMT did not differ between groups. At rest, carotid β stiffness was significantly higher in persons with DS (PObesity and particularly VO 2 peak influenced these findings. These results suggest impaired vascular function in people with DS.

  6. Excess pressure integral predicts cardiovascular events independent of other risk factors in the conduit artery functional evaluation substudy of Anglo-Scandinavian Cardiac Outcomes Trial.

    Science.gov (United States)

    Davies, Justin E; Lacy, Peter; Tillin, Therese; Collier, David; Cruickshank, J Kennedy; Francis, Darrel P; Malaweera, Anura; Mayet, Jamil; Stanton, Alice; Williams, Bryan; Parker, Kim H; McG Thom, Simon A; Hughes, Alun D

    2014-07-01

    Excess pressure integral (XSPI), a new index of surplus work performed by the left ventricle, can be calculated from blood pressure waveforms and may indicate circulatory dysfunction. We investigated whether XSPI predicted future cardiovascular events and target organ damage in treated hypertensive individuals. Radial blood pressure waveforms were acquired by tonometry in 2069 individuals (aged, 63±8 years) in the Conduit Artery Functional Evaluation (CAFE) substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Measurements of left ventricular mass index (n=862) and common carotid artery intima media thickness (n=923) were also performed. XSPI and the integral of reservoir pressure were lower in people treated with amlodipine±perindopril than in those treated with atenolol±bendroflumethiazide, although brachial systolic blood pressure was similar. A total of 134 cardiovascular events accrued during a median 3.4 years of follow-up; XSPI was a significant predictor of cardiovascular events after adjustment for age and sex, and this relationship was unaffected by adjustment for conventional cardiovascular risk factors or Framingham risk score. XSPI, central systolic blood pressure, central augmentation pressure, central pulse pressure, and integral of reservoir pressure were correlated with left ventricular mass index, but only XSPI, augmentation pressure, and central pulse pressure were associated positively with carotid artery intima media thickness. Associations between left ventricular mass index, XSPI, and integral of reservoir pressure and carotid artery intima media thickness and XSPI were unaffected by multivariable adjustment for other covariates. XSPI is a novel indicator of cardiovascular dysfunction and independently predicts cardiovascular events and targets organ damage in a prospective clinical trial.

  7. Microsurgical thromboendarterectomy of the cavernous carotid artery--case report and surgical technique.

    Science.gov (United States)

    Fujitsu, K; Fujii, S; Tanaka, N; Kuwabara, T

    1990-10-01

    A 53-year-old male suffered a transient right hemiparesis and left monocular blindness. Angiography revealed 80% stenosis of the cavernous carotid artery. Microsurgical thromboendarterectomy was performed by a direct approach through Parkinson's triangle. During surgery, the carotid circulation was transiently trapped between the cervical and the supraclinoid segment and the trapped arterial lumen was irrigated with heparinized saline. Soft elastic lesion was easily removed. Cavernous carotid thromboendarterectomy through a direct approach is considered as a suitable operation for the solitary and localized stenotic lesions of the cavernous carotid artery, although this operation has not yet been reported to date.

  8. Myocardial ischemia, carotid, and peripheral arterial disease and their interrelationship in type 2 diabetes patients

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Henriksen, Jan Erik; Dahl, Jordi;

    2009-01-01

    for the first time and age-matched nondiabetic reference subjects (n = 40) were screened for myocardial ischemia, carotid, and peripheral arterial disease by means of myocardial perfusion scintigraphy, carotid artery ultrasonography, and peripheral ankle and toe systolic blood pressure measurements. RESULTS......: In the T2DM patients, the prevalence of myocardial ischemia, carotid, and peripheral arterial disease was 30%, 42%, and 15%, respectively, almost three times higher than in the reference subjects (P = 0.007, P = 0.001, and P = 0.09, respectively). T2DM patients with myocardial ischemia, carotid...

  9. Endogenous nitric oxide synthase inhibitors, arterial hemodynamics, and subclinical vascular disease: the PREVENCION Study.

    Science.gov (United States)

    Chirinos, Julio A; David, Robert; Bralley, J Alexander; Zea-Díaz, Humberto; Muñoz-Atahualpa, Edgar; Corrales-Medina, Fernando; Cuba-Bustinza, Carolina; Chirinos-Pacheco, Julio; Medina-Lezama, Josefina

    2008-12-01

    Endogenous NO synthase inhibitors (end-NOSIs) have been associated with cardiovascular risk factors and atherosclerosis. In addition, end-NOSIs may directly cause hypertension through hemodynamic effects. We aimed to examine the association between end-NOSI asymmetrical dimethylarginine (ADMA) and N-guanidino-monomethyl-arginine (NMMA), subclinical atherosclerosis, and arterial hemodynamics. We studied 922 adults participating in a population-based study (PREVENCION Study) and examined the correlation between end-NOSI/L-arginine and arterial hemodynamics, carotid-femoral pulse wave velocity, and carotid intima-media thickness using linear regression. ADMA, NMMA, and L-arginine were found to be differentially associated with various classic cardiovascular risk factors. ADMA and NMMA (but not L-arginine) were significant predictors of carotid intima-media thickness, even after adjustment for cardiovascular risk factors, C-reactive protein, and renal function. In contrast, ADMA and NMMA did not predict carotid-femoral pulse wave velocity, blood pressure, or hemodynamic abnormalities. Higher L-arginine independently predicted systolic hypertension, higher central pulse pressure, incident wave amplitude, central augmented pressure, and lower total arterial compliance but not systemic vascular resistance or cardiac output. We conclude that ADMA and NMMA are differentially associated with cardiovascular risk factors, but both end-NOSIs are independent predictors of carotid atherosclerosis. In contrast, they are not associated with large artery stiffness, hypertension, or hemodynamic abnormalities. Our findings are consistent with a role for asymmetrical arginine methylation in atherosclerosis but not in large artery stiffening, hypertension, or long-term hemodynamic regulation. L-arginine is independently associated with abnormal pulsatile (but not resistive) arterial hemodynamic indices, which may reflect abnormal L-arginine transport, leading to decreased intracellular

  10. Risk stratification in asymptomatic and symptomatic patients with carotid artery stenosis

    OpenAIRE

    den Hartog, A.G.

    2013-01-01

    The overall aim of this thesis is to explore and assess the risks that patients with carotid artery disease, whether asymptomatic or symptomatic, are exposed to, and to explore whether patients that may be subject to relatively higher risk can be identified by imaging. Although large randomized trials have proven carotid endarterectomy (CEA) to be beneficial compared to best medical treatment alone, revascularization of patients with asymptomatic carotid artery stenosis (ACAS) remains a matte...

  11. Aterosclerose carotídea avaliada pelo eco-Doppler: associação com fatores de risco e doenças arteriais sistêmicas Carotid atherosclerosis evaluated by Doppler ultrasound: association with risk factors and systemic arterial disease

    Directory of Open Access Journals (Sweden)

    Procopio de Freitas

    2008-12-01

    Full Text Available CONTEXTO: A aterosclerose carotídea apresenta alta prevalência populacional e associação com vários fatores de risco, contribuindo para altos índices de morbidade e mortalidade. OBJETIVO: Pesquisar a freqüência e associação da aterosclerose de carótidas extracranianas com: idade, sexo, hipertensão arterial, doença coronária isquêmica, tabagismo, diabetes melito tipo 2, obesidade, doença arterial oclusiva periférica, acidente vascular cerebral, oclusão carotídea, espessamento médio-intimal e acotovelamento. MÉTODOS: Foram avaliadas as artérias carótidas extracranianas, bilateralmente, de 367 indivíduos (132 homens e 235 mulheres com idade média de 63 anos (35 a 91 anos por anamnese, semiologia clínica e ultra-sonografia. A possibilidade da associação entre aterosclerose carotídea representada por placas ateromatosas inespecíficas com estenose > 10%, ateromatose discreta e difusa com estenose 64 anos, acidente vascular cerebral, obesidade e tabagismo. Considerando-se somente estenoses carotídeas > 60%, houve associação com idade > 64 anos, oclusão carotídea e doença coronária. O espessamento médio-intimal apresentou associação com idade > 64 anos, acotovelamento, oclusão carotídea, hipertensão arterial e índice tornozelo-braquial BACKGROUND: A high prevalence of carotid atherosclerosis in the population and its frequent association with several risk factors contribute to high morbidity and mortality rates. OBJECTIVE: To investigate frequency and association of extracranial carotid atherosclerosis with age, sex, hypertension, ischemic coronary disease, smoking, type 2 diabetes mellitus, obesity, peripheral arterial disease, stroke, carotid occlusion, intima-media thickness and kinking. METHODS: The carotid and bilateral extracranial arteries of 367 individuals (132 males and 235 females, with a mean of 63 years of age (35-91 years were evaluated via anamnesis, clinical semiology and ultrasonography. The

  12. Changes in regional cerebral hemodynamics and its significance after internal carotid artery stenting in patients with moderate/severe internal carotid artery stenosis

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    Jia-chuan YAN

    2011-08-01

    Full Text Available Objective To evaluate the cerebral hemodynamic changes before and after carotid artery angioplasty and stenting.Methods Thirty-eight patients with moderate/severe internal carotid artery stenosis underwent carotid artery angioplasty and stenting.CT perfusion imaging was performed pre-and post-surgery to determine the cerebral blood flow(CBF,cerebral blood volume(CBV and mean transit time(MTT in the ipsilateral and contralateral cerebrum.Results Before angioplasty and stenting,the CBF and CBV decreased,and MTT increased in the ipsilateral cerebrum than in contralateral cerebrum.After intervention,the CBF and CBV increased and CTT shortened obviously in comparison with that of pre-surgery(P 0.05.Conclusion Angioplasty and stenting may improve the cerebral hemodynamics of patients with severe/moderate internal carotid artery stenosis.

  13. Wall stress of the cervical carotid artery in patients with carotid dissection: a case-control study.

    Science.gov (United States)

    Callaghan, Fraser M; Luechinger, Roger; Kurtcuoglu, Vartan; Sarikaya, Hakan; Poulikakos, Dimos; Baumgartner, Ralf W

    2011-04-01

    Spontaneous internal carotid artery (ICA) dissection (sICAD) results from an intimal tear located around the distal carotid sinus. The mechanisms causing the tear are unknown. This case-control study tested the hypotheses that head movements increase the wall stress in the cervical ICA and that the stress increase is greater in patients with sICAD than in controls. Five patients with unilateral, recanalized, left sICAD and five matched controls were investigated before and after maximal head rotation to the left and neck hyperextension after 45° head rotation to the left. The anatomy of the extracranial carotid arteries was assessed by magnetic resonance imaging and used to create finite element models of the right ICA. Wall stress increased after head movements. Increases above the 80th and 90th percentile were located at the intimal side of the artery wall from 7.4 mm below to 10 mm above the cranial edge of the carotid sinus, i.e., at the same location as histologically confirmed tears in patients with sICAD. Wall stress increase did not differ between patients and controls. The present findings suggest that wall stress increases at the intimal side of the artery wall surrounding the distal edge of the carotid bulb after head movements may be important for the development of carotid dissection. The lack of wall stress difference between the two groups indicates that the carotid arteries of patients with carotid dissection have either distinct functional or anatomical properties or endured unusually heavy wall stresses to initiate dissection.

  14. Stenting of Variant Left Carotid Artery Using Brachial Artery Approach in a Patient with Unusual Type of Bovine Aortic Arch

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    Emre Gürel

    2016-01-01

    Full Text Available Bovine aortic arch is the most frequently encountered variation in human aortic arch branching. A 63-year-old Asian male presented with symptomatic severe stenosis of left carotid artery originating from the brachiocephalic trunk. Selective engagement to the left carotid artery was unsuccessful using transfemoral approach. We reported on a successful left carotid artery stenting case using right brachial artery approach in a bovine aortic arch. This paper is worthy of reporting in terms of guiding physicians for interventional procedures in these types of challenging cases.

  15. The clinical analysis carotid artery ultrasound for the 54 patients who got coronary heart disease%冠心病患者54例颈动脉超声临床分析

    Institute of Scientific and Technical Information of China (English)

    吉红珠

    2013-01-01

      目的探讨颈动脉粥样硬化与冠状动脉粥样硬化的相关性。方法选择54例冠心病患者作为观察组,选择同期在我院体检的同年龄段患者作为对照组,用高频超声对2组患者进行颈动脉超声检查,观察2组颈动脉内膜变化。结果冠心病组颈动脉内膜变化与对照组比较差异有统计学意义(P<0.05)。结论据脑心同源,脑心同治理论,颈动脉超声所示颈动脉内膜变化可大致了解冠脉血管情况,应针对相关危险因素进行早期干预治疗。%Objective To investigate the correlation between carotid atherosclerosis and coronary atherosclerosis. Methods 54 cases of coronary heart disease patients as the observation group, select the same period in our hospital as control group with the same age Ultrasound of carotid artery were performed on two patients with high-frequency ultrasound,Ultrasound of carotid artery were performed on two patients with high-frequency ultrasound, According to the intima-media thickness (IMT) were divided into two groups, observation group two endometrial changes. Results the coronary heart disease group endometrial changes and control group had statistical significance. P<0.05. Conclusion According to the theory of brain and heart Tongzhi, according to carotid artery ultrasound shows carotid intimal changes can be a general understanding of coronary vessels,And early intervention treatment according to the related risk factors.

  16. Statins and their use in preventing carotid disease

    DEFF Research Database (Denmark)

    Sillesen, H.

    2009-01-01

    Carotid disease may be evaluated by surrogate outcomes, such as intima-media thickness and carotid plaque features, and by clinical end points. Statins stop progression or may induce regression of intima-media thickness, and statins may also stop plaque growth or even induce reduction of plaque...... volume. Areas rich in lipids within plaques may be reduced in size and/or in number of inflammatory cells. Ultrasound reflectivity may be reduced by statin treatment, indicating less lipid/inflammatory content. Finally, statins appear to reduce the risk of all cardiovascular events (eg, stroke...

  17. Classical surgical approach and treatment with clips of extracranial internal carotid artery berry aneurysm

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    Haris Vukas

    2016-06-01

    Full Text Available Introduction: We can define extracranial carotid artery aneurysm (ECAA as bulb dilatation greater than 200% of the diameter of the internal carotid artery (ICA or in a case of common carotid artery (CCA greater than 150% of the diameter. Surgical intervention is required for the treatment of this disease.Case report: This study presents an open vascular surgical procedure to resolve ECAA. We report a case of 61 years old woman with an extracranial internal carotid artery berry aneurysm, presented with a headache and dizziness when turning the head aside. Classic open surgery was performed and the lumen of berry aneurysm was separated with three clips from the lumen of ICA.Conclusions: The open surgical approach is the method of choice for the treatment of extracranial internal carotid artery pathological conditions.

  18. Computational model of collagen turnover in carotid arteries during hypertension.

    Science.gov (United States)

    Sáez, P; Peña, E; Tarbell, J M; Martínez, M A

    2015-02-01

    It is well known that biological tissues adapt their properties because of different mechanical and chemical stimuli. The goal of this work is to study the collagen turnover in the arterial tissue of hypertensive patients through a coupled computational mechano-chemical model. Although it has been widely studied experimentally, computational models dealing with the mechano-chemical approach are not. The present approach can be extended easily to study other aspects of bone remodeling or collagen degradation in heart diseases. The model can be divided into three different stages. First, we study the smooth muscle cell synthesis of different biological substances due to over-stretching during hypertension. Next, we study the mass-transport of these substances along the arterial wall. The last step is to compute the turnover of collagen based on the amount of these substances in the arterial wall which interact with each other to modify the turnover rate of collagen. We simulate this process in a finite element model of a real human carotid artery. The final results show the well-known stiffening of the arterial wall due to the increase in the collagen content.

  19. EVALUATION OF CAROTID ARTERY STENOSIS IN STROKE/TRANSIENT ISCHAEMIC ATTACK

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    Nambakam Tanuja

    2015-07-01

    Full Text Available BACKGROUND : Stroke remains the second leading cause of death worldwide, after ischaemic heart disease. Patients with carotid artery stenosis are at higher risk of development of stroke. Carotid atherosclerosis occurs in patients with atheros clerotic risk factors like diabetes mellitus, hypertension, smoking and hyperlipidemia. Carotid artery stenosis can be assessed by means of noninvasive high - resolution B - mode ultrasonography of the carotid arteries. AIMS AND O BJECTIVES: 1. To estimate the prevalence of carotid artery stenosis in ischaemic stroke/transient ishaemic attack patients. 2. To estimate whether there was any association between carotid artery stenosis and important risk factors such as diabetes mellitus, hypertension, hyper lipid emia with control group. METHODS AND MATERIALS : Acute ischaemic / TIA stroke patients with CT - Brain showing infarcts were enrolled for the study. All patients were subjected to CT scan brain study and colour Doppler study of extracranial carotid arteries. The systolic and diastolic velocity of blood flow, and the ratio of peak systolic velocities of common carotid arteries were assessed. RESULTS : DM, HTN, Smoking & Hyperlipidemia acted as risk factors for carotid stenosis. The prevalence of carotid stenosi s in our study was 60%. The prevalence of mild, moderate and severe stenosis were 34%, 10% and 16% respectively. The distribution of carotid stenosis was equal on both sides. The statistical significance was calculated using Chi - square test. Statistical si gnificance was taken when P value was <0.05. Statistical analysis was carried using standard formulae. Microsoft Excel 2007 and SPSS (Statistical Package for Social Sciences Version 17.0 software were used for data entry and analysis. CONCLUSIONS : Caroti d stenosis was one of the common causes of ischaemic stroke. There was a statistically significant correlation between increasing age, male gender, smoking, d iabetes mellitus, hypertension

  20. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2012-01-15

    Rarely in the anterior circulation, an anastomosis of the carotid and anterior cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid artery and anastomoses with the A1-A2 junction of the anterior communicating artery. Right-side predominance is known. To our knowledge, the incidence of carotid-anterior cerebral artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid-anterior cerebral artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the anterior cerebral artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid-anterior cerebral artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system. (orig.)

  1. The normal internal carotid artery: a computed tomography angiographic study

    Energy Technology Data Exchange (ETDEWEB)

    Koskinen, Suvi Maaria; Valanne, Leena; Silvennoinen, Heli [Helsinki University Central Hospital and University of Helsinki, Department of Radiology, HUS Medical Imaging Center, Helsinki (Finland); Soinne, Lauri [Helsinki University Central Hospital, Department of Neurology, Helsinki (Finland)

    2014-09-15

    Systematic computed tomography angiographic (CTA) studies investigating variation in internal carotid artery (ICA) luminal diameters (LDs) are scarce. Knowledge of the normal intra-individual LD variability would provide a cut-off value for detection of more subtle collapses. In addition, low intra-individual variability would allow using contralateral LD as a reference for estimation of stenosis degree in cases where ipsilateral measurement is hampered. Therefore, our aim was to investigate intra-individual LD variation of normal ICA. We retrospectively collected multidetector high-speed CTAs of 104 patients younger than 40 years who were considered not to have carotid pathology. We carried out independent measurements of the common carotid artery (CCA) and ICA LDs bilaterally from axial source images by two observers, analysing side-to-side LD differences from averaged double measurements with a paired t test. We discovered no significant side-to-side LD differences. In the female group, the mean differences (mm) with 95 % confidence intervals were 0.08 (0.00, 0.17) for CCA and 0.03 (-0.04, 0.11) for ICA, with ICA LD standard deviation of 0.4 mm. In the male group, these were: 0.06 (-0.04, 0.17), 0.02 (-0.07, 0.11) and 0.4 mm, respectively. We detected no ICA agenesis. The intrinsic intra-individual variation of the LD of normal ICA is minimal. This uniformity may serve as the basis for detection of subtle grades of side-to-side variation caused by pathology. (orig.)

  2. Rapid Formation of Cerebral Microbleeds after Carotid Artery Stenting

    Directory of Open Access Journals (Sweden)

    Kousuke Kakumoto

    2012-03-01

    Full Text Available Background: Recent studies reported that cerebral microbleeds (CMBs, i.e. small areas of signal loss on T2*-weighted gradient-echo (GE imaging, could develop rapidly after acute ischemic stroke. We hypothesized that CMBs rapidly emerge after carotid artery stenting (CAS. Objective: We investigated the frequency of and predisposing factors for CMBs after CAS. Methods: We retrospectively examined MRI before and after CAS in 88 consecutive patients (average age: 71.7 ± 7.2 years, average rates of carotid stenosis: 72.6 ± 12.8% who underwent CAS for carotid artery stenosis between March 1, 2009, and September 30, 2010. We defined new CMBs as signal losses that newly appeared on the follow-up GE. We examined the association of new CMBs with demographics, risk factors, and baseline MBs. Results: Among 88 patients, 18 (20.5% had CMBs initially, and 7 (8.0% developed new CMBs right after CAS. New CMBs appeared on the same side of CAS in all of the 7 patients. New CMBs appeared significantly more frequently in the CMB-positive group than in the CMB-negative one (22% vs. 4%, p = 0.03 on the pre-CAS MRI. Multivariate analysis also revealed that the presence of CMBs before CAS was an independent predictor of new development of CMBs after CAS (odds ratio: 8.09, 95% confidence interval: 1.39–47.1. Conclusion: CMBs can develop rapidly after CAS, especially in patients with pre-existing CMBs. Since the existence of CMBs prior to CAS suggests a latent vascular damage which is vulnerable to hemodynamic stress following CAS, particular attention should be paid to the prevention of intracerebral hemorrhage due to hyperperfusion after CAS.

  3. Prediction of Carotid Artery Stenosis in Candidates of Coronary Artery Bypasses Surgery by A Scoring System.

    Directory of Open Access Journals (Sweden)

    Sh. Shirani

    2007-05-01

    Full Text Available Background and Objective: Up to 9% of coronary ar-tery bypass grafting (CABG patients suffer from stroke after the surgery. Although post CABG stroke has multiple etiologies, stenosis of cervical carotid arteries is an important factor. Many studies have evaluated carotid artery stenosis in CABG. Carotid stenosis and its related factors and a new scoring sys-tem for selection of CABG patients for Doppler study are introduced. Materials and methods: 1721 consecutive cases of non-urgent CABG were evaluated for presence of significant carotid stenosis (> 50% stenosis. The asso-ciation of age, sex, hypertension, smoking, diabetes, dislipidemia and left main coronary stenosis with ca-rotid stenosis was evaluated. For introducing a scor-ing method, absence of each related factor was scored by 1 and its presence by 2. The score range for each patient was from 5 (none of related factors up to 10 (all of related factors. Results: 7% of patients suffered from significant stenosis. Female gender, age more than 55 years old, hypertension, diabetes, and stenosis of left main coronary artery were the related risk factors in uni-variate analysis. A step type analysis revealed patients with score 5 have 98.3% negative predictive value (NPV for significant stenosis with 96.2% sensitivity and 13.9% specificity. Patients with score 10 have 93.9% NPV for significant stenosis with 99.9% speci-ficity. Conclusion: This scoring system may help for better selection of patients for Doppler study before CABG.

  4. Feature selection applied to ultrasound carotid images segmentation.

    Science.gov (United States)

    Rosati, Samanta; Molinari, Filippo; Balestra, Gabriella

    2011-01-01

    The automated tracing of the carotid layers on ultrasound images is complicated by noise, different morphology and pathology of the carotid artery. In this study we benchmarked four methods for feature selection on a set of variables extracted from ultrasound carotid images. The main goal was to select those parameters containing the highest amount of information useful to classify the pixels in the carotid regions they belong to. Six different classes of pixels were identified: lumen, lumen-intima interface, intima-media complex, media-adventitia interface, adventitia and adventitia far boundary. The performances of QuickReduct Algorithm (QRA), Entropy-Based Algorithm (EBR), Improved QuickReduct Algorithm (IQRA) and Genetic Algorithm (GA) were compared using Artificial Neural Networks (ANNs). All methods returned subsets with a high dependency degree, even if the average classification accuracy was about 50%. Among all classes, the best results were obtained for the lumen. Overall, the four methods for feature selection assessed in this study return comparable results. Despite the need for accuracy improvement, this study could be useful to build a pre-classifier stage for the optimization of segmentation performance in ultrasound automated carotid segmentation.

  5. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS

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    N. V. Pizova

    2014-01-01

    Full Text Available Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD with severe extracranial artery atherosclerotic lesion.Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38.Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 % cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases, obesity (along with low activity, and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 % cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.

  6. 418例糖尿病患者颈动脉彩超结果及相关因素分析%Analysis of 418 Cases of Carotid Artery Color Doppler Results and Related Factors

    Institute of Scientific and Technical Information of China (English)

    孙飞; 李鼎; 邹翠文; 万钢; 申元; 吕玉洁; 韩子全; 杨再华; 杨玉平; 李海英; 牛文翠; 马卫华; 齐莹

    2015-01-01

    Objective Analysis the carotid artery color Doppler of diabetic patients and its relationship with metabolic factors, to find alternative indicators for pre-screen in the primary hospital. Methods According to the results of carotid artery ultrasonography, 418 patients were divided into normal group (intima-media of thickness<0.9mm, no plaque and stenosis) and abnormal (intima-media thickness ≥ 0.9mm of plaque or stenosis); select the factors related to metabolism (such as blood pressure, waist, neck circumference, BMI and blood glucose, blood lipid), compare the dif erences between the two groups of patients al relevant indexes. Results Carotid ultrasound in normal group, neck circumference, waist circumference, systolic blood pressure, which is significantly lower than that in abnormal group, there are significant dif erence between two groups ( <0.01);fasting blood glucose in normal group is lower than the abnormal group, there was significant dif erence between two groups ( <0.05);high density lipoprotein cholesterol in normal group is higher than the abnormal group, there was significant dif erence between two groups ( <0.01). Conclusion Neck circumference, waist circumference, systolic blood pressure, fasting blood glucose, HDL are associated with vascular disease, the neck circumference can be recommended as the pre screening index for carotid artery abnormal at primary hospital.%目的分析糖尿病患者颈动脉彩超的临床意义及其与代谢相关因素的相关性,以寻找在基层医院进行预筛时的替代指标。方法418例患者按照颈动脉彩超检查结果分为正常组(内中膜度厚度<0.9 mm、无斑块及狭窄)和异常组(内中膜度厚度≥0.9 mm有斑块或狭窄者);选取与代谢相关的因素(如血压、腰围、颈围、BMI、血糖、血脂)等数据,进行数据分析;比较两组患者各相关指标之间的差异。结果颈动脉检查正常组中颈围、腰围、收缩压,明显低于异常组

  7. ADMA/SDMA in Elderly Subjects with Asymptomatic Carotid Atherosclerosis: Values and Site-Specific Association

    Directory of Open Access Journals (Sweden)

    Graziano Riccioni

    2014-04-01

    Full Text Available Asymmetric dimethylarginine (ADMA is an endogenous nitric oxide synthase (NOS inhibitor known as a mediator of endothelial dysfunction and atherosclerosis. Circulating ADMA levels are correlated with cardiovascular risk factors such as hypercholesterolemia, arterial hypertension, diabetes mellitus, hyperhomocysteinemia, age and smoking. We assessed the relationship between ADMA values and site-specific association of asymptomatic carotid atherosclerosis (intima-media thickness (CIMT and plaque in elderly subjects. One hundred and eighty subjects underwent a complete history and physical examination, determination of serum chemistries and ADMA levels, and carotid ultrasound investigation (CUI. All subjects had no acute or chronic symptoms of carotid atherosclerosis. Statistical analyses showed that high plasma levels of ADMA/SDMA were positively correlated to carotid atherosclerosis (CIMT and plaque (p < 0.001, with significant site-specific association. Total cholesterol, low density lipoprotein cholesterol, triglycerides and C-reactive protein plasma concentrations were significantly associated with asymptomatic carotid atherosclerosis (p < 0.001. High serum concentrations of ADMA and SDMA were associated with carotid atherosclerotic lesions as measured by CIMT ad plaque and may represent a new marker of asymptomatic carotid atherosclerosis in elderly subjects.

  8. Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Karp Kjell

    2011-07-01

    Full Text Available Abstract Background Directed ultrasonic screening for carotid stenosis is cost-effective in populations with > 5% prevalence of the diagnosis. Occasionally, calcifications in the area of the carotid arteries are incidentally detected on odontological panoramic radiographs. We aimed to determine if directed screening for carotid stenosis with ultrasound is indicated in individuals with such calcifications. Methods This was a cross-sectional study. Carotid ultrasound examinations were performed on consecutive persons, with findings of calcifications in the area of the carotid arteries on panoramic radiography that were otherwise eligible for asymptomatic carotid endarterectomy. Results Calcification in the area of the carotid arteries was seen in 176 of 1182 persons undergoing panoramic radiography. Of these, 117 fulfilled the inclusion criterion and were examined with carotid ultrasound. Eight persons (6.8%; 95% CI 2.2-11.5% had a carotid stenosis - not significant over the 5% pre-specified threshold (p = 0.232, Binomial test. However, there was a significant sex difference (p = 0.008, as all stenoses were found in men. Among men, 12.5% (95%CI 4.2-20.8% had carotid stenosis - significantly over the 5% pre-specified threshold (p = 0.014, Binomial test. Conclusions The incidental finding of calcification in the area of the carotid arteries on panoramic radiographs should be followed up with carotid screening in men that are otherwise eligible for asymptomatic carotid endarterectomy. Trial Registration The study was registered at http://www.clinicaltrials.gov; NCT00514644

  9. Stress-induced cardiac autonomic reactivity and preclinical atherosclerosis: does arterial elasticity modify the association?

    Science.gov (United States)

    Chumaeva, Nadja; Hintsanen, Mirka; Pulkki-Råback, Laura; Merjonen, Päivi; Elovainio, Marko; Hintsa, Taina; Juonala, Markus; Kähönen, Mika; Raitakari, Olli T; Keltikangas-Järvinen, Liisa

    2015-01-01

    The effect of acute mental stress on atherosclerosis can be estimated using arterial elasticity measured by carotid artery distensibility (Cdist). We examined the interactive effect of acute stress-induced cardiac reactivity and Cdist to preclinical atherosclerosis assessed by carotid intima-media thickness (IMT) in 58 healthy adults aged 24-39 years participated in the epidemiological Young Finns Study. Cdist and IMT were measured ultrasonographically. Impedance electrocardiography was used to measure acute mental stress-induced cardiac autonomic responses: heart rate (HR), respiratory sinus arrhythmia and pre-ejection period after the mental arithmetic and the public speaking tasks. Interactions between HR reactivity and Cdist in relation to preclinical atherosclerosis were found. The results imply that elevated HR reactivity to acute mental stress is related to less atherosclerosis among healthy participants with higher arterial elasticity. Possibly, increased cardiac reactivity in response to challenging tasks is an adaptive reaction related to better cardiovascular health.

  10. Intracranial cerebral artery stenosis with associated coronary artery and extracranial carotid artery stenosis in Turkish patients

    Energy Technology Data Exchange (ETDEWEB)

    Alkan, Ozlem [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey)], E-mail: yalinozlem@hotmail.com; Kizilkilic, Osman; Yildirim, Tulin [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey); Atalay, Hakan [Department of Cardiovascular Surgery, Baskent University, Faculty of Medicine, Ankara (Turkey)

    2009-09-15

    Purpose: Although it has been demonstrated that there is a high prevalence of extracranial carotid artery stenosis (ECAS) in patients with severe coronary artery disease, intracranial cerebral artery stenosis (ICAS) is rarely mentioned. We evaluated the prevalence of ICAS in patients with ECAS having elective coronary artery bypass grafting (CABG) surgery to determine the relations between ICAS, ECAS and atherosclerotic risk factors. Methods: We retrospectively reviewed the digital subtraction angiography findings of 183 patients with ECAS {>=} 50% preparing for CABG surgery. The analyses focused on the intracranial or extracranial location and degree of the stenosis. The degree of extracranial stenoses were categorized as normal, <50%, 50-69%, 70-89%, and 90-99% stenosis and occluded. The degree of intracranial stenosis was classified as normal or {<=}25%, 25-49%, and {>=}50% stenosis and occluded. Traditional atherosclerotic risk factors were recorded. Results: ECAS < 70% in 42 patients and ECAS {>=} 70% in 141 patients. ICAS was found in 51 patients and ICAS {>=} 50% in 30 patients. Regarding risk factors, we found hypertension in 135 patients, diabetes mellitus in 91 patients, hyperlipidemia in 84 patients, and smoking in 81 patients. No risk factor was significant predictors of intracranial atherosclerosis. The severity of ICAS was not significantly associated with that of the ECAS. Conclusions: We found ICAS in 27.8% of the patients with ECAS > 50% on digital subtraction angiography preparing for CABG. Therefore a complete evaluation of the neck vessels with magnetic resonance or catheter angiography seems to be indicated as well as intracranial circulation for the risk assessment of CABG.

  11. Relationship between carotid intima media thickness and helminth infections on Flores Island, Indonesia

    NARCIS (Netherlands)

    Wiria, A.E.; Wammes, L.J.; Hamid, F.; Dekkers, O.M.; Prasetyani, M.A.; May, L.; Kaisar, M.M.; Verweij, J.J.; Tamsma, J.T.; Partono, F.; Sartono, E.; Supali, T.; Yazdanbakhsh, M.; Smit, J.W.A.

    2013-01-01

    OBJECTIVE: To examine the association between helminth infections and atherosclerosis. BACKGROUND: Chronic helminth infection, which can lead to poor nutritional status and anti-inflammatory response, might protect against the development of atherosclerosis. METHODS: A cross-sectional study was perf

  12. [Effect of pravastatine plus ezetimibe on carotid intima media thickness in patients with lupus erythematosus].

    Science.gov (United States)

    Vera-Lastra, Olga Lidia; Olvera-Acevedo, Arturo; Hernández, Claudia; Medina, Gabriela; Carrillo-González, Ana Laura; Ángeles-Garay, Ulises; Peralta-Amaro, Ana Lilia; Jara, Luis

    2015-01-01

    Introducción: Los pacientes con lupus eritematoso sistémico (LES) cursan con ateroesclerosis acelerada que puede ser evaluada mediante el grosor íntima-media carotídea (IMC). El uso de hipolipemiantes debe ser parte de su tratamiento. El objetivo de este estudio fue determinar el efecto de la terapia con pravastatina más ezetimibe en el grosor IMC en pacientes con LES.Métodos: estudio prospectivo, longitudinal, cuasi-experimental. De 60 paciente con LES a quienes se le realizó ultrasonido carotídeo, de los cuales se eligieron a 22 con grosor IMC > 0.7 mm y se les administró pravastatina más ezetimibe durante seis meses y posteriormente se determinó el grosor IMC. Se les determinó colesterol total (CT), colesterol HDL (c-HDL), colesterol LDL (c-LDL), triglicéridos, proteína C-reactiva (PCR), pruebas de funcionamiento hepático, enzimas musculares y glucosa basales y posterior al tratamiento. Análisis estadístico: estadística descriptiva y prueba de Wilcoxon.Resultados: se incluyeron 22 mujeres con edad 42 ± 6.3 años y evolución promedio 7.5± 6.6 años, de las cuales concluyeron el estudio 18 pacientes. El grosor IMC derecha basal fue de 0.829 ± 0.1448 frente a final 0.688 ± 0.1453, p < 0.003; el izquierdo 0.820±0.1312 frente a 0.724±0.1348, p < 0.004. El CT 208 mg/dl frente a 168 mg/dl, y el c-LDL 125 mg/dl frente a 72 mg/dl, p = 0.0004. Niveles de PCR 3.12 frente a 2.25 p = 0.004.Conclusiones: el tratamiento con pravastatina más ezetimibe disminuye el grosor IMC con mejoría en las concentraciones de colesterol total, colesterol LDL y niveles de PCR, así como buena tolerancia.

  13. Tortuous Common Carotid Artery: A Report of Four Cases Observed in Cadaveric Dissections

    Directory of Open Access Journals (Sweden)

    Joe Iwanaga

    2016-01-01

    Full Text Available A tortuous common carotid artery poses a high risk of injury during tracheotomy. Preoperative diagnosis is therefore important to avoid serious complications. We found four cases of tortuous common carotid artery during an anatomical dissection course for students. The first case was a 91-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 2 was a 78-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 3 was an 86-year-old woman who died from bladder cancer and who also had a right tortuous common carotid artery without arteriosclerosis. Case 4 was an 89-year-old woman who had bilateral tortuous common carotid arteries and a tortuous brachiocephalic artery with severe arteriosclerosis. Case 4 was also examined using computed tomography to evaluate the arteriosclerosis. Computed tomography revealed severe calcification of the vascular wall, which was confirmed in the aortic arch and origins of its branches. In all four cases, the tortuosity was located below the level of the thyroid gland. Based on prior study results indicating that fusion between the carotid sheath and visceral fascia was often evident at the level of the thyroid gland, we speculated that the major region in which tortuosity occurs is at the same level or inferior to the level of the thyroid gland.

  14. A STUDY OF ANATOMICAL VARIATIONS OF THE COMMON CAROTID ARTERIES: A CADAVERIC STUDY

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    Vatsala A R

    2014-03-01

    Full Text Available Background: Anatomical variations of carotid arterial system which are not infrequently encountered have a great impact on the surgical approaches of the neck. Although the described individual variations of the carotid arteries are well-known in the literature, the combination of anomalies reported in this study has not been, to the best of our knowledge, previously described. The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck. Methods:The present study was undertaken on 80 common carotid arteries (40 left, 40 right of both sexes from embalmed adult human cadavers. The specimens were studied by detailed dissection method. Results: In the present study,fiftyone (63.8% bifurcations of common carotid arteries were high among which the most common levels of bifurcation was at the level of C 3 vertebral body (37.5%. The origin of the right common carotid artery was high and low in 10% and 2.6% of vessels respectively. Conclusion: The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck.

  15. Alterations in adhesion molecules, pro-inflammatory cytokines and cell-derived microparticles contribute to intima-media thickness and symptoms in postmenopausal women.

    Science.gov (United States)

    Figueroa-Vega, Nicté; Moreno-Frías, Carmen; Malacara, Juan Manuel

    2015-01-01

    Menopause, the cessation of menses, occurs with estrogens decline, low-grade inflammation, and impaired endothelial function, contributing to atherosclerotic risk. Intima-media thickness (IMT) is an early subclinical biomarker of atherosclerosis. Inflammation may have a role on symptoms: hot flashes, anxiety, and depressive mood, which also are related to endothelial dysfunction, increased IMT and cardiovascular risk. In this study we compared several inflammatory markers in early vs. late postmenopausal women and studied the association of IMT and symptoms with these markers in the full sample. In a cross-sectional design including 60 women (53.1 ± 4.4 years old) at early and late postmenopause, we evaluated the expression of CD62L, ICAM-1, PSGL-1, CD11b, CD11c, and IL-8R on PBMC by flow cytometry. Serum soluble ICAM-1, sVCAM-1, sCD62E, sCD62P, CXCL8, IL-1β, IL-6, and TNF-α levels were quantified by ELISA. Plasma levels of microparticles (MPs) were determined by FACS. Finally, carotid intima-media thickness (IMT) was measured by ultrasound. We observed that ICAM-1 expression by lymphocytes and serum sVCAM-1 levels were augmented at late postmenopause. Late postmenopause women with severe hot flashes had increased expression of CD62L and IL-8R on neutrophils. By multivariate analysis, the carotid IMT was strongly associated with membrane-bound TNF-α, CD11b expression, Annexin V(+) CD3(+) MPs, LPS-induced NO production, HDL-cholesterol and age. Depressive mood was associated negatively with PSGL-1 and positively with LPS-induced NO. Finally, Log(AMH) levels were associated with carotid IMT, IL-8R expression and time since menopause. IMT and depressive mood were the main clinical features related to vascular inflammation. Aging, hormonal changes and obesity were also related to endothelial dysfunction. These findings provide further evidence for a link between estrogen deficiency and low-grade inflammation in endothelial impairment in mature women.

  16. Alterations in adhesion molecules, pro-inflammatory cytokines and cell-derived microparticles contribute to intima-media thickness and symptoms in postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Nicté Figueroa-Vega

    Full Text Available Menopause, the cessation of menses, occurs with estrogens decline, low-grade inflammation, and impaired endothelial function, contributing to atherosclerotic risk. Intima-media thickness (IMT is an early subclinical biomarker of atherosclerosis. Inflammation may have a role on symptoms: hot flashes, anxiety, and depressive mood, which also are related to endothelial dysfunction, increased IMT and cardiovascular risk. In this study we compared several inflammatory markers in early vs. late postmenopausal women and studied the association of IMT and symptoms with these markers in the full sample. In a cross-sectional design including 60 women (53.1 ± 4.4 years old at early and late postmenopause, we evaluated the expression of CD62L, ICAM-1, PSGL-1, CD11b, CD11c, and IL-8R on PBMC by flow cytometry. Serum soluble ICAM-1, sVCAM-1, sCD62E, sCD62P, CXCL8, IL-1β, IL-6, and TNF-α levels were quantified by ELISA. Plasma levels of microparticles (MPs were determined by FACS. Finally, carotid intima-media thickness (IMT was measured by ultrasound. We observed that ICAM-1 expression by lymphocytes and serum sVCAM-1 levels were augmented at late postmenopause. Late postmenopause women with severe hot flashes had increased expression of CD62L and IL-8R on neutrophils. By multivariate analysis, the carotid IMT was strongly associated with membrane-bound TNF-α, CD11b expression, Annexin V(+ CD3(+ MPs, LPS-induced NO production, HDL-cholesterol and age. Depressive mood was associated negatively with PSGL-1 and positively with LPS-induced NO. Finally, Log(AMH levels were associated with carotid IMT, IL-8R expression and time since menopause. IMT and depressive mood were the main clinical features related to vascular inflammation. Aging, hormonal changes and obesity were also related to endothelial dysfunction. These findings provide further evidence for a link between estrogen deficiency and low-grade inflammation in endothelial impairment in mature women.

  17. Endovascular treatment with angioplasty or stenting versus endarterectomy in patients with carotid artery stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long