Carotid wall sublayers and their association with atherosclerosis in hypertensive subjects

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.F.R Carvalho-Romano ◽  
R.P Bonafe ◽  
L.R Paim ◽  
E.R Marques ◽  
C.F.L Vegian ◽  
...  
Keyword(s):  
Layer Thickness ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Initial Step ◽  
Atherosclerotic Plaques ◽  
Funding Source ◽  
Cross Sectional ◽  
Carotid Imt ◽  
Carotid Wall ◽  
Media Layer

Abstract Introduction Intimal thickening is a characteristic and initial step of atherosclerosis. Carotid intima-media thickness (IMT) is considered a measure of subclinical atherosclerosis, but it can be influenced by increases not only of intima layer thickness (IT), but also of media layer thickness (MT). Hypertension is a risk factor for atherosclerosis, but may also stimulate media layer hypertrophy by increasing artery wall tension. However, little is known regarding the measures of carotid wall sublayers and their association with atherosclerosis in hypertensive subjects. Purpose To measure carotid IMT, MT and IT and evaluate their relationship with carotid atherosclerotic plaques in hypertensive subjects. Methods This cross-sectional study evaluated clinical and carotid characteristics of 186 hypertensive patients (age = 61±11 years, 43% men, BMI = 30.6±6.2 kg/m2) followed at a university outpatient clinic. High-resolution images of common carotid arteries wall and plaques were obtained by ultrasonography equipped with 10MHz-13MHz transducers. IMT, MT and IT were measured using an image processing software. Results Mean IT, MT and IMT values were 0.267±0.060, 0.475±0.107 and 0.742±0.142 mm, respectively. IMT showed stronger correlation with MT (r=0.92; p<0.001) than with IT (r=0.72; p<0.001). Patients with carotid plaques (n=100; 58% of the sample) had higher age (p<0.001) and carotid diastolic diameter (p=0.002) and a trend toward higher diabetes prevalence (p=0.06) than those without plaques. In logistic regression analysis adjusted for these variables, plaques showed stronger association with IT than with MT and IMT (Figure 1). In addition, IT showed greater area under the ROC curve (0.92; 95% CI 0.88–0.96) than IMT (0.79; 95% CI 0.72–0.85) and MT (0.64; 95% CI 0,56–0,72) to identify plaques. Conclusions MT is the main determinant of carotid IMT in hypertensive subjects. Conversely, IT showed stronger correlation and greater discriminatory value to identify atherosclerotic plaques than MT and IMT. These findings suggest that carotid IT may be a more accurate marker of atherosclerosis that MT or IMT in hypertensive subjects. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): CNPq

scholarly journals Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2098283
Author(s):  
María Lourdes Ladehesa-Pineda ◽  
Iván Arias de la Rosa ◽  
Clementina López Medina ◽  
María del Carmen Castro-Villegas ◽  
María del Carmen Ábalos-Aguilera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Structural Damage ◽  
Disease Duration ◽  
Linear Models ◽  
Axial Spondyloarthritis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Atherosclerotic Plaques ◽  
Cross Sectional

Aims: To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods: Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results: Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10–0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion: Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.

scholarly journals Dietary zinc intake is inversely related to subclinical atherosclerosis measured by carotid intima-media thickness

2010 ◽  
Vol 104 (8) ◽  
pp. 1202-1211 ◽  
Author(s):  
Yoon Jung Yang ◽  
Bo Youl Choi ◽  
Byung-Yeol Chun ◽  
Sun-Seog Kweon ◽  
Young-Hoon Lee ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Epidemiological Studies ◽  
Protective Role ◽  
Cross Sectional ◽  
Carotid Imt ◽  
Media Thickness ◽  
The Relationship

The relationship between dietary Zn intake and the risk of atherosclerosis remains unclear, and no epidemiological studies have been reported on the effects of dietary Zn intake on morphological changes in the vascular wall. We examined the relationship between dietary Zn intake and common carotid intima-media thickness (IMT) as a marker of subclinical atherosclerosis among the middle-aged and elderly populations. A cross-sectional analysis of a prospective cohort baseline study was performed with 4564 adults aged 40–89 years and free of clinical CVD. Dietary data were collected by trained interviewers using an FFQ. Common carotid IMT was measured using a B-mode ultrasound imaging technique. Subclinical atherosclerosis was determined using carotid IMT, and defined as >80th percentile of carotid IMT or ≥ 1 mm of carotid IMT. After adjustment for potential confounders, the mean carotid IMT in the low Zn intake group was higher than that in the high Zn intake group. When subclinical atherosclerosis was defined as >80th percentile value of IMT or ≥ 1 mm of carotid IMT, after adjustment for potential confounders, Zn intake was inversely related to subclinical atherosclerosis (5thv.1st quintile, OR 0·64, 95 % CI 0·45, 0·90,Pfor trend = 0·069; 5thv.1st quintile, OR 0·34, 95 % CI 0·16, 0·70,Pfor trend = 0·005, respectively). In persons free of clinical CVD, dietary Zn intake was inversely correlated with subclinical atherosclerosis. The present findings suggest a putative protective role of dietary Zn intake against the development of atherosclerosis.

scholarly journals The Relationship between Cardiovascular Risk Scores and Several Markers of Subclinical Atherosclerosis in an Asymptomatic Population

2021 ◽  
Vol 10 (5) ◽  
pp. 955
Author(s):  
Ovidiu Mitu ◽  
Adrian Crisan ◽  
Simon Redwood ◽  
Ioan-Elian Cazacu-Davidescu ◽  
Ivona Mitu ◽  
...  
Keyword(s):  
Risk Score ◽  
Subclinical Atherosclerosis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Risk Scores ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Single Center Study ◽  
Asymptomatic Individuals

Background: The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals. Methods: A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI). Results: The mean age was 52.01 ± 10.73 years. For cIMT—SCORE was more sensitive; for PWV—Framingham score was more sensitive; for AIXbr—QRISK and PROCAM were more sensitive while for AIXao—QRISK presented better results. As for SBPao—SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score. Conclusions: All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.

scholarly journals Linking cardiorespiratory fitness classification criteria to early subclinical atherosclerosis in children

2015 ◽  
Vol 40 (4) ◽  
pp. 386-392 ◽  
Author(s):  
Xavier Melo ◽  
Helena Santa-Clara ◽  
Diana A. Santos ◽  
Nuno M. Pimenta ◽  
Cláudia S. Minderico ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Arterial Wall ◽  
Operating Characteristic ◽  
Screening Tool ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
High Resolution Ultrasonography

It is unclear if cardiorespiratory fitness (CRF) can be used as a screening tool for premature changes in carotid intima-media thickness (cIMT) in paediatric populations. The purpose of this cross-sectional study was 3-fold: (i) to determine if CRF can be used to screen increased cIMT; (ii) to determine an optimal CRF cut-off to predict increased cIMT; and (iii) to evaluate its ability to predict increased cIMT among children in comparison with existent CRF cut-offs. cIMT was assessed with high-resolution ultrasonography and CRF was determined using a maximal cycle test. Receiver operating characteristic analyses were conducted in boys (n = 211) and girls (n = 202) aged 11–12 years to define the optimal sex-specific CRF cut-off to classify increased cIMT (≥75th percentile). Logistic regression was used to examine the association between the CRF cut-offs with the risk of having an increased cIMT. The optimal CRF cut-offs to predict increased cIMT were 45.81 and 34.46 mL·kg−1·min−1 for boys and girls, respectively. The odds-ratios for having increased cIMT among children who were unfit was up to 2.8 times the odds among those who were fit (95% confidence interval: 1.40–5.53). Considering current CRF cut-offs, only those suggested by Adegboye et al. 2011. (Br. J. Sports Med. 45(9): 722–728) and Boddy et al. 2012 (PLoS One, 7(9): e45755) were significant in predicting increased cIMT. In conclusion, CRF cut-offs (boys: ≤ 45.8; girls: ≤ 34.5 mL·kg−1·min−1) are associated with thickening of the arterial wall in 11- to 12-year-old children. Low CRF is an important cardiovascular risk factor in children and our data highlight the importance of obtaining an adequate CRF.

Anti-Müllerian Hormone Concentrations Are Inversely Associated With Subclinical Atherosclerosis in Premenopausal Women

Angiology ◽  
2020 ◽  
Vol 71 (6) ◽  
pp. 552-558 ◽  
Author(s):  
Irene Lambrinoudaki ◽  
Stefanos Stergiotis ◽  
Panagiota Chatzivasileiou ◽  
Areti Augoulea ◽  
Panagiotis Anagnostis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ovarian Reserve ◽  
Augmentation Index ◽  
Subclinical Atherosclerosis ◽  
Premenopausal Women ◽  
Reproductive Age ◽  
Inverse Association ◽  
Cross Sectional ◽  
Carotid Imt ◽  
Negatively Associated

Anti-Müllerian hormone (AMH), which is secreted by granulosa cells of late preantral and small antral follicles, is a marker of ovarian reserve. The association of ovarian reserve with subclinical atherosclerosis in women of reproductive age is currently unknown. We primary investigated whether AMH levels are associated with markers of subclinical atherosclerosis in healthy, normally menstruating women. In this cross-sectional study, vascular structure and function were assessed by measurement of carotid and femoral intima–media thickness (IMT), flow-mediated dilation, carotid–femoral pulse wave velocity and augmentation index. Lipid profile and serum AMH concentrations were also measured. Seventy premenopausal women, aged 32.7 ± 6.5 years, were included. Mean AMH levels were lower in smokers than in non-smokers and negatively associated with total cholesterol (TC) levels. An inverse association between mean AMH concentrations and femoral and carotid IMT in all segments was observed. No correlation with other markers of subclinical atherosclerosis or established cardiovascular (CV) risk factors was found. After multivariable adjustment, the association between AMH concentrations and combined carotid IMT or carotid bulb IMT remained significant. In conclusion, in healthy, normally ovulating women, AMH concentrations are negatively associated with subclinical atherosclerosis indices and TC levels, independently of established CV risk factors.

scholarly journals Circulating heat shock protein 27 as a novel marker of subclinical atherosclerosis in type 2 diabetes: a cross-sectional community-based study

2020 ◽  
Author(s):  
Xinru Wang ◽  
Jie Shi ◽  
Bin Lu ◽  
Weiwei Zhang ◽  
Yehong Yang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heat Shock ◽  
Heat Shock Protein ◽  
Subclinical Atherosclerosis ◽  
Heat Shock Protein 27 ◽  
Diabetic Patients ◽  
Community Based ◽  
Cross Sectional ◽  
Carotid Imt

Abstract Background Heat shock protein 27 (HSP27) has been proposed as a vital protective factor in atherosclerosis. The objective of the present study was to evaluate the association between circulating HSP27 and intima–media thickness (IMT) of the common carotid artery in individuals with type 2 diabetes and to determine whether HSP27 represents an independent marker for subclinical atherosclerosis in this patient population. Methods We performed a cross-sectional community-based study consisting in 186 Chinese subjects with a median duration of diabetes of 8.2 years who underwent carotid ultrasound IMT measurement. Serum HSP27 levels were assessed by ELISA. Results Serum HSP27 levels were significantly higher in the IMT (+, >1.0 mm) group than in the IMT (-, ≤1.0 mm) group, with the median value of 8.80 ng/mL (5.62–12.25) and 6.93 ng/mL (4.23–9.60), respectively ( P =0.006). The discriminative value of HSP27 to evaluate IMT was 7.16 ng/mL and the area under the curve was 0.72 (95%CI=0.64–0.80, P=0.0065). Spearman's rank correlation analysis demonstrated that the concentrations of circulating HSP27 were positively correlated with carotid IMT ( r =0.198, P =0.007) and blood urea nitrogen ( r =0.170, P <0.05). Furthermore, in the logistic model, serum HSP27 levels were found to be independent predictors of carotid IMT in type 2 diabetic patients after adjustment for onset age of diabetes, blood pressure, total cholesterol and C-reactive protein. (OR=1.085, P =0.022). Conclusions Circulating HSP27 level, positively correlates with carotid IMT, is an independent predictor for early atherosclerotic changes in diabetes, and may represent a novel marker of subclinical atherosclerosis in type 2 diabetes.

scholarly journals Independent associations of urinary albumin-to-creatinine ratio and serum cystatin C with carotid intima-media thickness in community-living Taiwanese adults

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiu-Shong Liu ◽  
Chia-Ing Li ◽  
Yuh-Cherng Guo ◽  
Chih-Hsueh Lin ◽  
Wen-Yuan Lin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cystatin C ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Carotid Imt ◽  
Low Hdl ◽  
Hs Crp

Abstract Background Renal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. The determinants of cystatin C, a novel marker of renal function, have not been extensively studied in the Asian population. This study aimed to assess the determinants of cystatin C and explore whether carotid thickening was associated with urinary albumin-creatinine ratio and cystatin C in community-living Taiwanese adults. Methods A cross-sectional study was conducted on participants from Taichung City, Taiwan. All the participants underwent carotid ultrasonography. Carotid IMT-mean and IMT-maximum were derived. Kidney biomarkers were measured on the basis of urinary albumin-to-creatinine ratio (ACR) and cystatin C. Multiple linear regression analysis was used. Results A total of 1032 individuals were recruited, and 469 (45.44%) of them were men. An increased cystatin C level was significantly associated with older age, male gender, lack of physical activity, low HDL cholesterol, abdominal obesity, high hs-CRP, and high ACR. The multivariate-adjusted mean carotid IMT-mean and IMT-maximum values significantly increased by 80.49 and 195.23 μm for every one unit of increase in cystatin C level and by 0.07 and 0.14 μm for every one unit of increase in ACR, respectively (all p < 0.001 except ACR on IMT-maximum with p < 0.01). Lack of physical activity, low HDL, abdominal obesity, high hs-CRP, and high ACR were the determinants of cystatin C. Conclusion Cystatin C and ACR were strongly and linearly associated with carotid thickening, a marker of subclinical atherosclerosis.

Abstract P047: Association of 1,5-anhydroglucitol with Subclinical Cardiovascular Disease

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Menglu Liang ◽  
John William (Bill) McEvoy ◽  
Yuan Chen ◽  
A. Richey Sharrett ◽  
Elizabeth Selvin
Keyword(s):  
Cardiovascular Disease ◽  
Regression Models ◽  
Troponin T ◽  
Subclinical Atherosclerosis ◽  
Myocardial Damage ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cardiac Damage ◽  
Cross Sectional ◽  
Subclinical Cardiovascular Disease

Introduction: Serum 1,5-anhydroglucitol (1,5-AG) concentrations decrease in the setting of acute hyperglycemia, making 1,5-AG a useful biomarker of glucose peaks. In recent studies, 1,5-AG has been associated with clinical cardiovascular disease events. However, the association between 1,5-AG and subclinical vascular disease is unknown. Hypothesis: 1,5-AG will be associated with subclinical myocardial damage (assessed by cardiac troponin T measured using a novel highly sensitive assay (hs-cTnT)) and subclinical atherosclerosis (assessed by ultrasound-detected carotid intima-media thickness (cIMT)), particularly in persons with diabetes. Methods: We measured 1,5-AG in 10,753 participants in the ARIC Study at visit 2 (1990[[Unable to Display Character: &#8211;]]1992) and conducted a cross-sectional analysis to characterize the associations of 1,5-AG with elevated hs-cTnT (≥ 14 ng/L) or thick cIMT (top quartile, ≥0.79 mm) using logistic regression models. We also evaluated the prospective association between baseline 1,5-AG and incident elevated hs-cTnT at 6-years using Poisson regression models. Results: Among diabetics, those with 1,5-AG <6 ug/mL were 5 times more likely to have prevalent elevated hs-TnT at baseline compared to non-diabetics with 1,5-AG >10 ug/mL (adjusted OR 4.67, 95%CI, 3.27[[Unable to Display Character: &#8211;]]6.68) and almost 2 times more likely to be in the top quartile of the cIMT (adjusted OR 1.75, 95%CI 1.39-2.19). 1,5-AG <6 ug/mL in persons with diabetes was also significantly associated with 6-year incident elevated hs-TnT: RR 2.26 (95%CI, 1.50[[Unable to Display Character: &#8211;]]3.39). The associations of 1,5-AG with elevated hs-TnT and thick cIMT were non-linear and mostly driven by persons with diabetes (Figure). Conclusions: 1,5-AG was associated with prevalent and incident subclinical cardiovascular disease in persons with diabetes in the community. Our results suggest that glucose peaks may be relevant for the development of subclinical cardiac damage and atherosclerosis in persons with diabetes.

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