Changes in carotid artery intima-media thickness during the cardiac cycle – a comparative study in early childhood, mid-childhood, and adulthood

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 275-281 ◽  
Author(s):  
Kuna Rueb ◽  
Jonathan Mynard ◽  
Richard Liu ◽  
Melissa Wake ◽  
Peter Vuillermin ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Cardiac Cycle ◽  
Age Groups ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cine Sequence ◽  
Carotid Imt ◽  
Media Thickness ◽  
Adults And Children ◽  
The Right

Abstract. Background: Carotid intima-media thickness (CIMT), an ultrasonographic marker of cardiovascular risk, is increasingly used in adults and children. The choice of specific images used to quantify CIMT from a cine sequence is often based on image quality rather than on a consistent point in the cardiac cycle. This methodological study quantified the imprecision that may be introduced by variation of CIMT during the cardiac cycle. Probands and methods: Data from four-year-olds, 11 to 12-year-olds, and adults (n=30 each age group) were selected retrospectively from two population-derived studies. Far wall CIMT of the right common carotid artery was measured at end-diastole and peak systole using standardized protocols. All images were analysed using semi-automated edge-detection software. Results: In all age groups CIMT varied significantly during the cardiac cycle and was largest at end-diastole. The mean difference in CIMT between end-diastole and peak systole was greater in four-year-olds (38 μm; 95 % confidence interval (CI) 33 to 43 μm) and 11 to 12-year-olds (31 μm; CI 26 to 36 μm) than in adults (18 μm; CI 16 to 22 μm). Carotid IMT increased by 8.8 % (CI 7.7 to 9.8 %), 6.9 % (CI 5.8 to 8.1 %), and 3.8 % (CI 3.1 to 4.5 %) between minimum and maximum arterial diameter in four-year-olds, 11 to 12-year-olds, and adults, respectively. The greatest variation in CIMT during the cardiac cycle was observed in children (up to 14 %). Conclusions: Inconsistent timing of CIMT measurement during the cardiac cycle is an avoidable source of imprecision, especially in children, in whom inter-individual differences are smallest. As CIMT is largest at end-diastole, this is the most appropriate time point for consistent and comparable measurements to be made.

scholarly journals Carotid artery intima–media thickness, distensibility and elasticity: population epidemiology and concordance in Australian children aged 11–12 years old and their parents

BMJ Open ◽  
2019 ◽  
Vol 9 (Suppl 3) ◽  
pp. 23-33 ◽  
Author(s):  
Richard S Liu ◽  
Sophie Dunn ◽  
Anneke C Grobler ◽  
Katherine Lange ◽  
Denise Becker ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Correlation Coefficients ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Repeated Measurements ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Carotid Imt ◽  
Media Thickness ◽  
Parent Child

ObjectivesTo describe a well-established marker of cardiovascular risk, carotid intima–media thickness (IMT) and related measures (artery distensibility and elasticity) in children aged 11–12 years old and mid-life adults, and examine associations within parent–child dyads.DesignCross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven Australian major cities and eight selected regional towns, February 2015 to March 2016.ParticipantsOf all participating CheckPoint families (n=1874), 1489 children (50.0% girls) and 1476 parents (86.8% mothers) with carotid IMT data were included. Survey weights and methods were applied to account for LSAC’s complex sample design and clustering within postcodes and strata.Outcome measuresUltrasound of the right carotid artery was performed using standardised protocols. Primary outcomes were mean and maximum far-wall carotid IMT, quantified using semiautomated edge detection software. Secondary outcomes were carotid artery distensibility and elasticity. Pearson’s correlation coefficients and multivariable linear regression models were used to assess parent–child concordance. Random effects modelling on a subset of ultrasounds (with repeated measurements) was used to assess reliability of the child carotid IMT measure.ResultsThe average mean and maximum child carotid IMT were 0.50 mm (SD 0.06) and 0.58 mm (SD 0.05), respectively. In adults, average mean and maximum carotid IMT were 0.57 mm (SD 0.07) and 0.66 mm (SD 0.10), respectively. Mother–child correlations for mean and maximum carotid IMT were 0.12 (95% CI 0.05 to 0.23) and 0.10 (95% CI 0.03 to 0.21), respectively. For carotid artery distensibility and elasticity, mother–child correlations were 0.19 (95% CI 0.10 to 0.25) and 0.11 (95% CI 0.02 to 0.18), respectively. There was no strong evidence of father–child correlation in any measure.ConclusionsWe provide Australian values for carotid vascular measures and report a modest mother–child concordance. Both genetic and environmental exposures are likely to contribute to carotid IMT.

scholarly journals The role of thyroid hormones in carotid arterial wall remodeling in women

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maida Seferovic Saric ◽  
Miljenka-Jelena Jurasic ◽  
Hrvoje Budincevic ◽  
Milan Milosevic ◽  
Bojana Kranjcec ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Thyroid Hormones ◽  
Subclinical Hypothyroidism ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Control Group ◽  
Carotid Imt ◽  
Atherosclerosis Development ◽  
The Right

Abstract Introduction: Thyroid hormones affect the cardiovascular system, but the precise mechanisms of their effects on the development of atherosclerosis are not entirely clear. The relationship between subclinical hypothyroidism, dyslipidemia and carotid atherosclerosis has been widely investigated, but the findings were controversial. The aim of the present study was to determine whether female subjects with subclinical hypothyroidism (SHypo) have increased carotid intima-media thickness (IMT) compared with euthyroid subjects, as well as to examine the association of SHypo, carotid atherosclerosis and dyslipidemia. Methods: This research included 100 women aged 30 to 70 years who were divided into two groups: the SHypo group including subjects with signs of subclinical hypothyroidism and the control group of euthyroid subjects. Carotid IMT thickness using B mode ultrasound was determined and its correlation with serum concentrations of fT4, TSH, CRP, and lipid profile including small dense LDL (sdLDL) was analysed. Results: Subjects with SHypo had significantly increased carotid IMT (IMT ≥ 75th centile) in all three measured segments of the right (p <0.001) and the left (p = 0.001) carotid artery compared to the control group, with a significantly more frequent appearance of plaque (25% vs. 9%; p = 0.05). Significant positive correlations were found between higher TSH and higher IMT values. Increased age, LDL cholesterol, and TSH predicted thickening of the carotid artery IMT. Conclusions: It is important to screen people showing early, subclinical signs of thyroid gland dysfunction due to its impact on carotid atherosclerosis development.

scholarly journals Carotid intima-media thickness and hemodynamic parameters: reproducibility of manual measurements with Doppler ultrasound

2015 ◽  
Vol 17 (2) ◽  
pp. 167 ◽  
Author(s):  
Juana M Plasencia Martinez ◽  
Jose M Garcia Santos ◽  
Maria L Paredes Marti­nez ◽  
Ana Moreno Pastor
Keyword(s):  
Intraclass Correlation ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Ultra Sound ◽  
Hemodynamic Parameters ◽  
Carotid Ultrasound ◽  
Carotid Imt ◽  
Media Thickness ◽  
The Common ◽  
The Right

Aims: To evaluate the carotid ultrasound intra- and interobserver agreements in a common clinical scenario when making manual measurements of the intima-media thickness (IMT) and peak systolic (PSV) and end diastolic (EDV) velocities in the common (CCA) and the internal carotid (ICA) arteries. Material and methods: Three different experienced operators per- formed two time-point carotid ultrasounds in 21 patients with cardiovascular risk factors. Each operator measured freehand the CCA IMT three consecutive times in each examination. The CCA and ICA hemodynamic parameters were acquired just once. For our purpose we took the average (IMTmean) and maximum (IMTmax) IMT values. Quantitative variables were analyzed with the t-student, and ANOVA test. Agreements were evaluated with the Intraclass Correlation Coefficient (ICC). Results: IMTmean intraobserver agreement was better on the left (ICC: 0.930-0.851-0.916, operators 1-2-3) than on the right (ICC: 0.789-0.580-0.673, operators 1-2-3). IMTmax agreements (Left ICC: 0.821-0.723-0.853, operators 1-2-3; Right ICC: 0.669- 0.421-0.480, operators 1-2-3) were lower and more variable. Interobserver agreements for IMTmean (ICC: 0.852-0.860; first-second ultrasound) and IMTmax (ICC: 0.859-0.835; first-second ultrasound) were excellent on the left, but fair-good and more variable on the right (IMTmean; ICC: 0.680-0.809; first-second ultrasound; IMTmax; 0.694-0.799; first-second ultra- sound). Intraobserver agreements were fair-moderate for PSVs and good-excellent for EDVs. Interobserver agreements were good-excellent for both PSVs and EDVs. Overall, 95% confidence intervals were narrower for the left IMTmean and CCA velocities. Conclusions: Intra and interobserver agreements in carotid ultrasound are variable. In order to improve carotid IMT agreements, IMTmean is preferable over IMTmax.

scholarly journals Soya isoflavone consumption in relation to carotid intima–media thickness in Chinese equol excretors aged 40–65 years

2012 ◽  
Vol 108 (9) ◽  
pp. 1698-1704 ◽  
Author(s):  
Yun Cai ◽  
Kaiping Guo ◽  
Chaogang Chen ◽  
Ping Wang ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Serum Lipids ◽  
Plasma Lipids ◽  
Hdl Cholesterol ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Dietary Intakes ◽  
Media Thickness ◽  
The Right ◽  
Usual Diet

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.

Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

2018 ◽  
Vol 69 (6) ◽  
pp. 1550-1553
Author(s):  
Rosana Manea ◽  
Bianca Elena Popovici ◽  
Carmen Daniela Neculoiu ◽  
Dan Minea ◽  
Alina Calin
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diagnostic Methods ◽  
Control Group ◽  
Study Group ◽  
Media Thickness ◽  
Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

scholarly journals Sitagliptin on carotid intima-media thickness in type 2 diabetes and hyperuricemia patients: a subgroup analysis of the PROLOGUE study

2021 ◽  
Vol 12 ◽  
pp. 204062232110269
Author(s):  
Yipin Zhao ◽  
Huawei Wang ◽  
Dazhi Ke ◽  
Wei Deng ◽  
Yingying Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Carotid Artery ◽  
Conventional Therapy ◽  
Therapy Group ◽  
Controlled Trial ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Significant Difference

Background and Aims: Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia. Methods: The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period. Results: In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT. Conclusion: The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.

Abstract P218: Carotid Intima-media Thickness and Incident End-stage Renal Disease: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Yuanjie Pang ◽  
Yingying Sang ◽  
Shoshana Ballew ◽  
Morgan Grams ◽  
Gerardo Heiss ◽  
...  
Keyword(s):  
Renal Disease ◽  
Kidney Function ◽  
End Stage Renal Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Carotid Imt ◽  
Media Thickness ◽  
Hazard Ratios ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Carotid intima-media thickness (IMT) has been reported to predict kidney function decline. However, whether carotid IMT is associated with a hard kidney endpoint, end-stage renal disease (ESRD), has not been investigated. Hypothesis: We assessed the hypothesis that increased carotid IMT is associated with ESRD risk. Methods: We studied 13,197 ARIC participants at visit 1 (1987-1989) without history of cardiovascular disease including coronary heart disease, stroke and heart failure and assessed whether carotid IMT measured by B-mode ultrasound is associated with ESRD risk using Cox proportional-hazards models. Regarding carotid IMT parameters, we investigated the mean and maximum values of overall and segment-specific (common, bifurcation and internal carotid arteries) measurements. Results: Mean age was 54.0 (SD 5.7) years, and there were 3,373 (25.6%) blacks and 7,370 (55.8%) women. During a median follow-up of 22.7 years, 433 participants developed ESRD (1.4/1,000 person-years). After adjusting for shared risk factors for atherosclerosis and kidney disease, including baseline kidney function, carotid IMT was significantly associated with ESRD risk (hazard ratios between quartiles 4 and 1, 1.43 [95%CI: 1.01-2.04] for overall mean IMT and 1.73 [95%CI: 1.22-2.44] for overall maximum IMT). The associations were largely consistent in demographic and clinical subgroups. When we explored segment-specific IMTs, the associations with ESRD were most robust for bifurcation carotid. The adjusted hazard ratios between quartiles 4 and 1 were 1.48 (95%CI: 1.04-2.11) for mean bifurcation IMT and 1.42 (95%CI: 0.99-2.03) for maximum bifurcation IMT. Conclusions: Carotid IMT was independently associated with incident ESRD in the general population. Our findings suggest the shared etiology between atherosclerosis and ESRD and highlight the importance of monitoring kidney function over time in individuals with subclinical atherosclerosis.

Multiparametric Ultrasound to Assess Adult Carotid Arteries

2020 ◽  
Vol 44 (3) ◽  
pp. 144-149
Author(s):  
Juhyun Lee ◽  
Andrew Phan ◽  
Jing Gao
Keyword(s):  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Age Groups ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Pearson Correlation Coefficient ◽  
Media Thickness ◽  
Ultrasound Parameters ◽  
Multiparametric Ultrasound ◽  
Distensibility Coefficient

The aim of the study was to assess the value of multiparametric ultrasound in atherosclerotic cardiovascular disease risk screening of the carotid artery. We performed ultrasonography of carotid arteries in 96 adults in 3 age groups: senior (age ≥65 years, n = 44), middle age (age 45-64 years, n = 31), and young adults (age 20-44 years, n = 21). The senior group was then divided into subgroups: athletes (n = 21) and non-athletes (n = 23). Ultrasound parameters included carotid intima-media thickness, distensibility coefficient, and presence of plaque(s). Statistical analyses included one-way analysis of variance with post hoc to analyze the differences in ultrasound parameters among the age groups; unpaired t-test to examine differences between hypertensive and normotensive participants, between seniors with and without plaque(s), and between senior athletes and non-athletes; Pearson correlation coefficient to analyze correlations of ultrasound parameters to age and blood pressure; and intraclass correlation coefficient to test intra- and inter-observer reliability in performing multiparametric ultrasound. Carotid intima-media thickness and distensibility coefficient significantly differed among the 3 age groups and between athletes and non-athletes ( P < .001). Senior athletes had greater distensibility than non-athletes (all Ps < .05). Carotid intima-media thickness was increased and distensibility was reduced with age and hypertension. Age and blood pressure positively correlated with carotid intima-media thickness (Pearson correlation coefficient, r > .21) and negatively with distensibility coefficient (Pearson correlation coefficient, r < –.48). Inter- and intra-observer reliability in performing multiparametric ultrasound was good (intraclass correlation coefficient, r > .81). Multiparametric ultrasound is a useful tool to assess carotid artery function and morphology comprehensively.

scholarly journals INTIMA-MEDIA THICKNESS OF THE CAROTID ARTERIES IS AFFECTED BY PUBERTAL MATURATION IN HEALTHY ADOLESCENTS

2019 ◽  
Vol 37 (4) ◽  
pp. 428-434 ◽  
Author(s):  
Jovita Lane Soares Santos Zanini ◽  
Tânia Maria Barreto Rodrigues ◽  
Cristina Botelho Barra ◽  
Maria Francisca Tereza Freire Filgueiras ◽  
Ivani Novato Silva
Keyword(s):  
Clinical Laboratory ◽  
Task Force ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
World Health ◽  
Pubertal Stage ◽  
Pubertal Maturation ◽  
Media Thickness ◽  
Ultrasound Evaluation ◽  
The Right

ABSTRACT Objective: To contribute to the assessment of normal parameters of carotid intima-media thickness (CIMT) in healthy adolescents. Methods: A cross-sectional study was conducted through clinical, laboratory and ultrasound evaluation in 61 healthy adolescents. The inclusion criteria consisted of being in good health. The exclusion criteria were: presence or history of any chronic disease; being obese or overweight according to the World Health Organization (WHO) established criterion; continuous use of medication; or presenting a febrile condition or requiring medication within 48-hours prior to assessment. The pubertal stages were evaluated using the Tanner criteria. The high-resolution B-mode ultrasound examinations were performed according to the recommendations of the Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Results: Adolescents were 14±2.6 years old, 62.3% female, 19 (31%) at early puberty (Tanner II and III), and 38 (62%) at late puberty (Tanner IV and V). They presented normal clinical and laboratorial parameters. CIMT values were 0.46±0.04 to 0.55±0.04 mm on the right and 0.48±0.02 to 0.53±0.04 mm on the left, according to pubertal maturation. CIMT values increased significantly on the right and left sides, according to pubertal stage (p<0.001 and p=0.016), and maximum internal diameters of the common carotid artery (p<0.025 and p<0.003). It was higher in males compared to females. Conclusions: An increase in CIMT in the healthy adolescents group, according to both age, and the degree of pubertal maturation should be considered when evaluating adolescents in diagnostic procedures.

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