What is the role of non-invasive measurements of atherosclerosis in individual cardiovascular risk prediction?

2007 ◽  
Vol 112 (10) ◽  
pp. 507-516 ◽  
Author(s):  
Ewoud ter Avest ◽  
Anton F. H. Stalenhoef ◽  
Jacqueline de Graaf
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Risk Prediction ◽  
Pulse Wave ◽  
Imaging Techniques ◽  
Non Invasive ◽  
Cardiovascular Risk Prediction

Primary prevention of CVD (cardiovascular disease) is mainly based on the assessment of individual cardiovascular risk factors. However, often, only the most important (conventional) cardiovascular risk factors are determined, and every level of risk factor exposure is associated with a substantial variation in the amount of atherosclerosis. Measuring the effect of risk factor exposure over time directly in the vessel might (partially) overcome these shortcomings. Several non-invasive imaging techniques have the potential to accomplish this, each of these techniques focusing on a different stage of the atherosclerotic process. In this review, we aim to define the current role of various of these non-invasive measurements of atherosclerosis in individual cardiovascular risk prediction, taking into account the most recent insights about validity and reproducibility of these techniques and the results of recent prospective outcome trials. We conclude that, although the clinical application of FMD (flow-mediated dilation) and PWA (pulse wave analysis) in individual cardiovascular risk prediction seems far away, there may be a role for PWV (pulse wave velocity) and IMT (intima-media thickness) measurements in the near future.

scholarly journals Elevated levels of urine isocitrate, hydroxymethylglutarate, and formiminoglutamate are associated with arterial stiffness in Korean adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ji-Hee Haam ◽  
Young-Sang Kim ◽  
Doo-Yeoun Cho ◽  
Hyejin Chun ◽  
Sang-Woon Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Cardiovascular Risk Factors ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Urinary Metabolites ◽  
Metabolic Disturbances ◽  
Liquid Chromatograph

AbstractRecent evidence suggests that cellular perturbations play an important role in the pathogenesis of cardiovascular diseases. Therefore, we analyzed the association between the levels of urinary metabolites and arterial stiffness. Our cross-sectional study included 330 Korean men and women. The brachial-ankle pulse wave velocity was measured as a marker of arterial stiffness. Urinary metabolites were evaluated using a high-performance liquid chromatograph-mass spectrometer. The brachial-ankle pulse wave velocity was found to be positively correlated with l-lactate, citrate, isocitrate, succinate, malate, hydroxymethylglutarate, α-ketoisovalerate, α-keto-β-methylvalerate, methylmalonate, and formiminoglutamate among men. Whereas, among women, the brachial-ankle pulse wave velocity was positively correlated with cis-aconitate, isocitrate, hydroxymethylglutarate, and formiminoglutamate. In the multivariable regression models adjusted for conventional cardiovascular risk factors, three metabolite concentrations (urine isocitrate, hydroxymethylglutarate, and formiminoglutamate) were independently and positively associated with brachial-ankle pulse wave velocity. Increased urine isocitrate, hydroxymethylglutarate, and formiminoglutamate concentrations were associated with brachial-ankle pulse wave velocity and independent of conventional cardiovascular risk factors. Our findings suggest that metabolic disturbances in cells may be related to arterial stiffness.

scholarly journals Carotid intima–media thickness and cardiovascular risk factors in healthy volunteers

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Birgit-Christiane Zyriax ◽  
Kira Dransfeld ◽  
Eberhard Windler
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Risk Prediction ◽  
Framingham Risk Score ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Continuous Variables ◽  
Framingham Risk ◽  
Low Cardiovascular Risk

Abstract Background Assessment of cardiovascular risk by scores lacks sensitivity and leaves the majority of future cardiovascular patients unidentified particularly individuals at low cardiovascular risk. The present analysis investigates into the correlation of carotid intima–media thickness (CIMT) and cardiovascular risk factors and derived scores as to the potential of improved cardiovascular risk prediction by combining the two. Methods The Stress, Atherosclerosis and ECG Study (STRATEGY) is a cross-sectional study of selectively healthy 107 women and 106 men without diagnosed and treated cardiovascular risk factors evenly distributed between 30 and 70 years. CIMT was determined by evaluating B-mode ultrasonograms offline according to a standardized protocol. The unpaired t-test was used to compare normal-distributed continuous variables, the Chi-squared test for normal-distributed categorical variables and the Mann–Whitney U test for non-normal distributed continuous variables. The association between risk prediction scores and CIMT was calculated by the Spearman rank correlation coefficient. Pearson correlation coefficient was used for the correlation between cardiovascular risk factors and CIMT. A multiple linear regression analysis was executed for the association of cardiovascular risk factors and CIMT. Results Age, systolic blood pressure, fasting glucose, total, LDL- and non-HDL-cholesterol and waist circumference were significantly associated with CIMT (each P ≤ 0.03). The Framingham Risk Score, the Prospective Cardiovascular Münster Study Score and the European Society of Cardiology Score correlated significantly but only moderately with CIMT. The Framingham Risk Score considering BMI correlated most strongly and predicted 27% of the CIMT variance in men and 20% in women. Conclusion In individuals without overt cardiovascular risk factors and thus at low cardiovascular risk, CIMT and cardiovascular risk factors correlated only partially suggesting that combining CIMT and conventional risk factors or common derived scores may improve risk prediction in individuals at low cardiovascular risk. The clinical benefit as to cardiovascular events of such combined risk prediction needs to be explored in large prospective cohorts of still healthy low-risk volunteers. DRKS ID DRKS00015209 07/02/2019 retrospectively registered https://www.drks.de/drks_web/navigate.do?navigationId=resultsExt

scholarly journals POS-296 CARDIOVASCULAR RISK PREDICTION WITH AORTIC PULSE WAVE VELOCITY: A CARTAGENE STUDY

2021 ◽  
Vol 6 (4) ◽  
pp. S127
Author(s):  
S. Veillette ◽  
F. Lamarche ◽  
M. Agharazii ◽  
S. Wassertheurer ◽  
B. Hametner ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Pulse Wave Velocity ◽  
Risk Prediction ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Cardiovascular Risk Prediction

Carotid–femoral pulse wave velocity acquisition methods and their associations with cardiovascular risk factors and subclinical biomarkers of vascular health

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kunihiko Aizawa ◽  
Phillip E. Gates ◽  
David M. Mawson ◽  
Salim Elyas ◽  
Francesco Casanova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Pulse Wave Velocity ◽  
Cardiovascular Risk Factors ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Vascular Health

scholarly journals Standardised measurement of coronary inflammation using cardiovascular CT: integration in clinical care as a prognostic medical device

2021 ◽  
Author(s):  
Evangelos K Oikonomou ◽  
Alexios S Antonopoulos ◽  
David Schottlander ◽  
Mohammad Marwan ◽  
Chris Mathers ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Medical Device ◽  
Risk Prediction ◽  
Clinical Care ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Cardiovascular Risk Prediction ◽  
Perivascular Fat

Abstract Aims Coronary CT angiography (CCTA) is a first-line modality in the investigation of suspected coronary artery disease (CAD). Mapping of perivascular Fat Attenuation Index (FAI) on routine CCTA enables the non-invasive detection of coronary artery inflammation by quantifying spatial changes in perivascular fat composition. We now report the performance of a new medical device, CaRi-Heart®, which integrates standardised FAI mapping together with clinical risk factors and plaque metrics to provide individualised cardiovascular risk prediction. Methods and Results The study included 3912 consecutive patients undergoing CCTA as part of clinical care in the United States (n = 2040) and Europe (n = 1872). These cohorts were used to generate age-specific nomograms and percentile curves as reference maps for the standardised interpretation of FAI. The first output of CaRi-Heart® is the FAI-Score of each coronary artery, which provides a measure of coronary inflammation adjusted for technical, biological and anatomical characteristics. FAI-Score is then incorporated into a risk prediction algorithm together with clinical risk factors and CCTA-derived coronary plaque metrics to generate the CaRi-Heart® Risk that predicts the likelihood of a fatal cardiac event at 8 years. CaRi-Heart® Risk was trained in the US population and its performance was validated externally in the European population. It improved risk discrimination over a clinical risk factor-based model (Δ[C-statistic] of 0.085, P = 0.01 in the US Cohort and 0.149, P < 0.001 in the European cohort) and had a consistent net clinical benefit on decision curve analysis above a baseline traditional risk factor-based model across the spectrum of cardiac risk. Conclusion CaRi-Heart® reliably improves cardiovascular risk prediction by incorporating traditional cardiovascular risk factors along with comprehensive CCTA coronary plaque and perivascular adipose tissue phenotyping. This integration advances the prognostic utility of CCTA for individual patients and paves the way for its use as a screening tool among patients referred for CCTA. Translational Perspective Mapping of perivascular Fat Attenuation Index (FAI) on coronary computed tomography angiography (CCTA) enables the non-invasive detection of coronary artery inflammation by quantifying spatial changes in perivascular fat composition. We now report the performance of a new medical device, CaRi-Heart®, which integrates standardised FAI mapping together with clinical risk factors and plaque metrics to provide age-standardised reference maps and individualised cardiovascular risk prediction. This integration advances the prognostic value of CCTA and paves the way for its use as a screening tool among patients referred for CCTA.

scholarly journals Relationship between serum leptin levels, non-cardiovascular risk factors and mortality in hemodialysis patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ivona Risovic ◽  
Vlastimir Vlatkovic ◽  
Snjezana Popovicpejicic ◽  
Gabrijela Malešević
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Survival Rates ◽  
Inverse Correlation ◽  
Study Groups ◽  
Mineral And Bone Disorder ◽  
Serum Leptin ◽  
Significant Difference

Abstract Introduction. Hemodialysis (HD) patients have higher mortality rate than the general population. Recent studies indicate a significant role of non-cardiovascular risk factors in for mortality in HD patients. Leptin is protein hormone and may indicate malnutrition in HD patients. Its role in mortality in these patients is being examined. This study aimed to investigate the correlation between serum leptin levels and non-cardiovascular risk factors and relationship between leptin level and mortality in HD patients. Methods The prospective study included 93 patients on maintenance HD and follow-up period was 12 months. We measured leptin level and evaluated non-cardiovascular risk factors: nutritional status, anemia, volemia, parameters of mineral and bone disorder. Results. Out of 93 patients 9 died during study and 1 underwent kidney transplantation. Malnutrition and hypervolemia were two main non-cardiovascular risk factors among deceased subjects. Leptin showed a significant direct correlation with nutritional BMI (r = 0.72, P <0.001), fat tissue index (r = 0.74, P <0.001) and statistically significant inverse correlation with leantissue index (r = -0.349, P <0.05) and inverse correlation with volemic parameters (overhydration / extracellular water ratio (r = -0.38, P <0.001), but no association with anemia and mineral bone parameters was observed. Elevated leptin levels were associated with better survival. However, no statistically significant difference in survival rates was observed between the study groups (Log-Rank P =0.214, Breslow P =0.211, Tarone-Ware P=0.212). Conclusion: Deceased patients had significantly lower leptin values. Leptin was associated with two non-cardiovascular risk factors for mortality: malnutrition and hypervolemia.

scholarly journals Role of green tea in reduction of cardiovascular risk factors

2010 ◽  
pp. 85
Author(s):  
Charalambos Vlachopoulos ◽  
Alexopoulos ◽  
Stefanadis
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Green Tea
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