scholarly journals AB0186 AT WHAT LEVEL SHOULD WE MEASURE INTIMA-MEDIA THICKNESS IN RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1117.3-1118
Author(s):  
L. Nacef ◽  
H. Ferjani ◽  
H. Riahi ◽  
K. Maatallah ◽  
Y. Mabrouk ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
University Hospital ◽  
External Carotid ◽  
Media Thickness ◽  
The Mean ◽  
The Right ◽  
Score Index

Background:Rheumatoid arthritis (RA) is chronic inflammatory rheumatism characterized by an independent cardiovascular (CV) risk. The screening of carotid intima-media thickness (IMT) in the common carotid artery appears to be a marker of atherosclerosis and is used as a specific tool for CV risk assessment.Objectives:The main of this study was to determine the most associated US sites with CV risk in RA.Methods:The present study is a prospective study conducted on Tunisian RA patients in rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected. The measurement of cIMTwas done using high-resolution B-mode carotid US with a Philips machine with the patient in supine position, according to AmericanSociety of Echocardiography guidelines.The carotid bulb below itsbifurcation and the internal and external carotid arteries were evaluated bilaterally with gray scale, spectral and color Doppler ultra-sonography using proprietary software for carotid arterymeasurements.IMT was measured using the two inner layers of the commoncarotid artery and an increased IMT was defined as ≥0.9 mm. The CV risk at 10 years was calculated by the SCORE index.Results:Forty-seven patients were collected, of which 78.7% were women. The mean age was 52.5 ±11.06 years. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients and diabetes in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The mean SCORE index of CV risk was 2±2.81 [0-11.6]. CV risk was significantly associated with the IMTs for LIC (p=0.029; r=0.374), LEC (p=0.04; r=0.480), and REC (p=0.016; r=0.408). No association was found between the IMT in the LCC (p=0,361; r=0,162), neither in the RCC (p=0,438; r=0,140) nor the RIC (p=0,670; r=0,077).Conclusion:In our study, IMT is strongly associated with score index, especially in carotid bifurcation. However, IMT measured in common carotid does not reflect a cardiovascular risk at 10-years.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.Disclosure of Interests:None declared

scholarly journals POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
External Carotid ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

scholarly journals AB0191 ON WHICH FACTOR TO ACT TO REDUCE CARDIOVASCULAR RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1119.3-1120
Author(s):  
L. Nacef ◽  
H. Ferjani ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
E. Labbene ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Active Smoking ◽  
Media Thickness ◽  
Modifiable Factors ◽  
Internal Carotid Arteries

Background:Patients with rheumatoid arthritis (RA) are at higher cardiovascular risk (CVR) than the general population due to chronic inflammation. Several factors, both modifiable and non-modifiable, can increase this risk. Intima-media thickness (IMT) was considered as a marker for atherosclerosis.Objectives:This study aimed to identify predictor factors of increasing IMT.Methods:The prospective study was carried out on patients with RA who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria. These patients were followed in the rheumatology department of the Kassab Institute. The socio-demographic data, biological and immunological parameters were collected.Framingham’s score quantified the cardiovascular risk at 10-years. Carotid Ultrasonography (US) using a high resolution B mode carotid measured intima-media thickness (IMT) as a subclinical marker of atherosclerosis. Carotid US was performed in the supine position, according to American Society of Echocardiography guidelines. IMT was measured in the left (LCC) and right (RCC) common carotid arteries, the left (LIC) and right (RIC) internal carotid arteries, and the left (LEC) and right (RIC) internal carotid arteries. An increased IMT was defined as ≥0.9 mm.We analyzed data by the SPSS statistical package. A p-value <0.05 was considered significant.Results:Of the 47 patients surveyed, 78.7% were female. The mean age was 52.5 ±11.06 [32-76]. The duration disease was 86.25 ±63 months [5-288] and was erosive in 81.6% of cases. The rheumatoid factor (RF) was positive in 57.8% of patients, and citrullinated antipeptide antibodies (ACPA) were present in 62.2%. Eight patients had a previous CV history (hypertension, diabetes or dyslipidemia) and 16.4% were active smokers. Among women, 43.6% were postmenopausal. ITM was significantly higher in men at LIC (0.037) and LEC (0.025). Older age was associated with increased ITM in LIC (p=0.046; r=0.295), LEC (p=0.05; r=0.412), RCC (p=0.034; r=0.317), and REC (p=0.009; r=0.382). The ITM for LCC, LIC, LEC, RCC, RIC, and REC was higher in postmenopausal women, with no significant difference (p=0.782, p=0.208, p=0.877, r=0.734, p=0.808, p=0.437, respectively).Among the modifiable factors, active smoking was associated with a higher ITM at the REC level (p=0.047). However, weight was not associated with an increased ITM (LCC: p=0.092; LIC: p=0.985; LEC: p=0.952; RCC: p=0.744; RIC: p=0.210; REC: p=0.510). In our study, there was no significant association between DAS28 disease activity or inflammatory marks and ITM (LCC: p=0.784; LIC: p=0.316; LEC: p=0.420; RCC: p=0.784; RIC: p=0.484; REC: p=0.754).Conclusion:In our study, the non-modifiable factors associated with increased ITM were advanced age and male gender. The modifiable factor impacting ITM was primarily active smoking. Surprisingly, disease activity and biological inflammation did not influence ITM.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and experimental rheumatology 2018; 36: clinical e.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid Arthritis. Scandinavian cardiovascular journal, 2017.[3]Martin i. Wah-suarez and al, carotid ultrasound findings in rheumatoid arthritis and control subjects: a case-control study. Int j rheum dis. 2018;1–7.Disclosure of Interests:None declared

Validation of an Automated Computerized Analyzing System for Measuring Common Carotid Artery Intima–Media Thickness by Brightness Mode Ultrasound

2005 ◽  
Vol 29 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Helmuth F. Fritz ◽  
Roy V. Jutzy ◽  
Ramesh Bansal ◽  
Linda Housten-Feenstra
Keyword(s):  
Carotid Artery ◽  
Validation Study ◽  
Common Carotid Artery ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Accuracy Analysis ◽  
Electronic Instrument ◽  
Carotid Ultrasound ◽  
Media Thickness ◽  
The Mean

Background and Purpose Evaluation of subclinical atherosclerosis by B-mode carotid ultrasound intima–media thickness (IMT) is an endorsed technique whose ease and precision is improved by use of automated IMT measurement algorithms. We report results of a validation study of SonoCalc, an automated IMT software program. Methods Three vascular sonographers measured the mean common carotid artery IMT twice of 120 near and far wall CCA segments from 30 subjects by manual electronic instrument calipers and with SonoCalc. Results Accuracy analysis indicated the equivalence of SonoCalc IMT measurements to those with manual electronic instrument calipers ( p < 0.0001). The coefficient of variation (CV) was calculated for each set of duplicate SonoCalc and manual electronic instrument calipers measurements. The average SonoCalc-manual electronic instrument calipers CV differences significantly favored SonoCalc ( p < 0.0001). Conclusion This study demonstrated that the use of the SonoCalc and the manual electronic instrument calipers produced measurements whose differences were statistically insignificant. Furthermore, the analysis to assess reproducibility of the two methods showed that the SonoCalc method was significantly more reproducible than the manual electronic instrument calipers methods.

AB0277 Comparison between Intima-Media Thickness and Coronary Artery Tomography in Subclinical Atherosclerosis Detection in Rheumatoid Arthritis:

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 994.2-994
Author(s):  
L. Riancho-Zarrabeitia ◽  
A. Corrales ◽  
J.A. Parra ◽  
M. Santos-Gόmez ◽  
V. Portilla ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Coronary Artery ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Media Thickness

scholarly journals Factors affecting carotid intimal medial thickness in patients with rheumatoid arthritis, an analytical cross-sectional study

2019 ◽  
Vol 6 (3) ◽  
pp. 628
Author(s):  
K. M. Prabhuswamy ◽  
M. Virgin Joena
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional ◽  
Media Thickness ◽  
The Mean

Background: IMT assessment as a non-invasive imaging test is quite widely used especially among RA patients, the clinical applications of using such knowledge is scarce, hence study was conducted to compare the carotid artery intima-media thickness (CIMT) in patients with rheumatoid arthritis (RA) with healthy controls also to study the correlation between duration of rheumatoid arthritis, the activity of rheumatoid arthritis and other factors influencing (CIMT).Methods: In analytical cross-sectional study, of 80 participants of RA and 40 healthy controls, “DAS28” was used to assess disease activity.  Carotid intima-media thickness assessed using carotid ultrasonography.Results: Mean age of the cases and controls was 43.9 and 44.38 years. Subjects with duration of disease <2 years, to 5 years and >5 years were 35%, 45% and 20%. The mean carotid intima-media thickness was 5.61mm in controls, and CIMT was 6.11mm in people below 2 years and 7.08 mm in people between 2 to 5 years and 8.00mm in people above 5 years which was statistically significant. The mean carotid intima-media thickness was 5.61mm controls and 6.86mm in people with low, 7.00mm in people with moderate and 6.95mm in people with high disease activity, which was statistically significant.Conclusions: Study findings revealed risk of increase in carotid intima-media thickness higher among RA patients in the later stages and can increase the patients’ susceptibility to cardiovascular events. The factors showing strong association with intimal medial thickness were the age and symptoms duration.

scholarly journals Correlation Between Carotid Intima-Media Thickness and the Activity of Rheumatoid Arthritis: A 1-Year Cross-Sectional Study

2018 ◽  
Vol 30 (3) ◽  
pp. 34-41
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Media Thickness ◽  
Das 28 ◽  
Significant Difference ◽  
The Mean

Background and objectives: Among several noninvasive techniques available, a high-resolution B-mode ultrasonography is the widely used technique to measure carotid intima-media thickness (CIMT) in rheumatoid arthritis (RA) patients with elevated cardiovascular risk. The present study was undertaken to explore the clinical relationship between CIMT and disease activity in patients with RA. Methods: This study involved 50 adult patients with RA. Demographic, physical, systemic, and clinical data and history of the patients were recorded. Investigations, such as erythrocyte sedimentation rate, highly sensitive C-reactive protein, renal and liver function tests, RA factor, and anticyclic citrullinated peptide antibody tests were performed. CIMT was assessed using highresolution B-mode ultrasonography and the disease severity was assessed based on disease activity score (DAS) 28. Results: The mean age of the RA patients was 49.88 ± 12.12 years with male predilection. The mean duration, mean European League Against Rheumatism (EULAR) criteria score, and mean DAS 28 score in RA patients were 3.62 ± 3.25 years, 8.10 ± 1.58, and 4.91 ± 1.11, respectively. The mean CIMT observed in RA patients was 0.94 ± 0.31 cm. Significant difference was observed in the mean CIMT values of different variables, including duration of joint pain (P = 0.007), tender joint count (P < 0.001), swollen joint count (P < 0.001), EULAR criteria score (P < 0.001), and DAS 28 score (P < 0.001). Also, CIMT correlated positively with tender joint count (r = 0.711; P < 0.001), swollen joint count (r = 0.673; P < 0.001), EULAR criteria score (r = 0.611; P < 0.001), and DAS 28 score (r = 0.729; P < 0.001). Conclusion: A strong correlation was observed between CIMT and disease activity in patients with RA. Hence, CIMT can be a useful surrogate marker for detecting atherosclerosis in patients with RA.

scholarly journals Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

2021 ◽  
pp. 38-48
Author(s):  
Riham A. El-Sehly ◽  
Abeer A. Shahba ◽  
Raghda G. Elsheik ◽  
Mahmoud F. Selim
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Function ◽  
Disease Activity ◽  
Brachial Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
University Hospital ◽  
Control Group ◽  
Carotid Imt ◽  
Media Thickness

Introduction: Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in RA disease. In active RA patients, the majority of cardiovascular deaths result from accelerates atherosclerosis. Aim of the Work: The aim of this work is to assess carotid intima media thickness (C-IMT) and endothelial function by brachial artery flow mediated dilatation (FMD) in Rheumatoid arthritis patients and relation to the disease activity. Subjects and Methods: Our study included 50 RA patients, from Tanta University Hospital. 47 women and 3 men and their age ranged from 30-62 years.  They were divided into group 1:  25 active RA patients, group 2:  25 inactive RA patients who were   diagnosed by American College of Rheumatology (ACR) revised criteria for diagnosis of RA 1987 and disease activity was evaluated using disease activity score 28(DAS28). Group 3: 25 normal subjects as a control group.  We measured C-IMT and FMD in all groups. Results: By comparing the groups, we found that active RA patients had increased C-IMT compared to inactive rheumatoid arthritis patients and controls which is indicator of atherosclerosis. FMD of the brachial artery impaired in RA patients compared to controls which is indicator of endothelial dysfunction. There was highly statistically significant relation between duration, activity of RA disease and atherosclerosis in RA patients. Conclusion: With increasing the frequency of atherosclerosis in asymptomatic RA patients, carotid IMT increased and FMD impaired when compared with general population. Active RA patients have increased carotid IMT and impaired FMD compared with inactive RA patients.

scholarly journals Assessment of carotid intima-media thickness in hypothyroidism and the effect of thyroid replacement therapy

2018 ◽  
Vol 5 (2) ◽  
pp. 281
Author(s):  
Varun Vijayan ◽  
Jayasingh K. ◽  
Jayaraman G. ◽  
Siva Ranganathan Green ◽  
Deyagarasan E.
Keyword(s):  
Body Mass Index ◽  
Total Cholesterol ◽  
Intima Media Thickness ◽  
Thyroid Function Test ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Function Test ◽  
The Mean ◽  
The Right ◽  
Progression Of Atherosclerosis

Background: Carotid artery intima-media thickness (CAIMT) measurement in hypothyroidism will help assess the progression of atherosclerosis and timely intervention may prevent vascular complications.Methods: This study included 30 clinical hypothyroid (CH), 30 subclinical hypothyroid (SCH) and 30 euthyroid. As per procedure, informed consent was taken from the patients in prescribed formats before their participation in the study. Patients were divided into 3 groups of CHs, SCH and Controls after obtaining the thyroid function test values. CAIMT on the right side was measured in the three groups for comparison. Other parameters included age, sex, height, weight, body mass index (BMI), total cholesterol and triglycerides. After 4 months of levothyroxine therapy, CAIMT, total cholesterol and triglycerides were reassessed.Results: The CAIMT was increased in CH and SCH group when compared to euthyroid individuals. The mean CAIMT in CH group was 0.60±0.009cm, in SCH group it was 0.055±0.010 cm and in controls it was 0.047±0.006 cm. After 4 months of levothyroxine therapy, there was no change observed in the mean CAIMT values.Conclusions: CAIMT levels were increased in CH and SCH group when compared to euthyroid group. There was no regression of CAIMT after 4 months of levothyroxine therapy.

scholarly journals Association between carotid intima media thickness and metabolic syndrome

2018 ◽  
Vol 5 (6) ◽  
pp. 1503
Author(s):  
Abhishek T. G. ◽  
Arathi Darshan ◽  
Jayaprakash S. Appajigol ◽  
Naveen Angadi ◽  
Vijayalakshmi Chikkamath
Keyword(s):  
Metabolic Syndrome ◽  
Total Cholesterol ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional Study ◽  
Research Centre ◽  
Cross Sectional ◽  
Media Thickness ◽  
The Mean

Background: Metabolic syndrome and its individual criteria pose a risk for atherosclerosis and cardiovascular disease (CVD). Carotid intima media thickness (CIMT) is a well-known marker of subclinical atherosclerosis. This study was aimed to assess CIMT in patients with metabolic syndrome.Methods: This one year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2016 to December 2016. A total of 100 patients diagnosed to have metabolic syndrome based on national cholesterol education program adult treatment panel III (NCEP ATP III) criteria were studied. All the patients were subjected to carotid B mode ultrasonography.Results: The most common age group was 51 to 60years (29%). Out of 100 individuals who were diagnosed to have metabolic syndrome, 60% had five criteria, 29% had four criteria and 3% had three criteria. Most of the of the individuals (61.00%) had normal (≤0.10cms) CIMT while high (>0.10cm) levels were noted in 39.00% of the individuals. The mean CIMT was noted as 0.13±0.16cms. The mean SBP (150.15±10.39 vs 142.98±20.09mmHg; p=0.042), DBP (94.51±6.53 vs 90.16±9.91 mmHg; p=0.017), total cholesterol levels (243.53±65.74 vs 195.95±29.8 mg/dL; p<0.001) and triglyceride levels (221.07±48.44 vs 180.85±24.74mg/dL; p <0.001) were noted in individuals with raised CIMT compared to individuals with normal CIMT. Majority of the individuals had abnormal HDL (93.00%) and 41.94% of the individuals with abnormal HDL had raised CIMT (p=0.027).Conclusions: Some individuals with metabolic syndrome are likely to have raised CIMT. The rise in CIMT among the patients with metabolic syndrome is associated with raised SBP, DBP, abnormal HDL (specifically in males), total cholesterol and triglycerides.

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