Carotid Artery Temperature Reduction with Statin Therapy in Patients with Familial Hyperlipidemia Syndromes

Background: Microwave radiometry (MWR) assesses non-invasive carotid artery temperatures reflecting inflammation. In the present study, we aimed to investigate the impact of hypolipidemic therapy either with simvastatin or with combination simvastatin plus ezetimibe on carotid artery temperatures of patients with familial hyperlipidemia syndromes (FHS). Methods: Consecutive patients with diagnosis of either familial heterozygous hypercholesterolemia (heFH) or familial combined hyperlipidemia (FCH) were included in the study. Patients were assigned to either simvastatin 40 mg or simvastatin 40 mg plus ezetimibe 10 mg, according to the discretion of the physician. FHS patients who refused statin therapy were used as a control group. Common carotid intima-media thickness (ccIMT) was measured and ΔΤ (maximum-minimum) temperature measurements were performed across each carotid during MWR evaluation. RESULTS: In total, 115 patients were included in the study. Of them, 40 patients received simvastatin (19 heFH and 21 FCH), 41 simvastatin + ezetimibe (31 heFH and 10 FCH), and 34 (21 heFH and 13 FCH) no statin. Carotid artery temperatures were significantly reduced at 6 months in FH patients who received hypolipidemic treatment (0.83 ± 0.34 versus 0.63 ± 0.24 oC, p = 0.004 for simvastatin, 1.00 ± 0.38 versus 0.69 ± 0.23 oC, p < 0.001 for simvastatin+ezetimibe), but no change was recorded in controls (0.72 ± 0.26 versus 0.70 ± 0.26 oC, p = 0.86). CONCLUSIONS: Hypolipidemic therapy reduced carotid temperatures in FHS patients.

Download Full-text

Carotid artery temperature reduction with statin therapy in patients with familial hyperlipidemia syndromes

European Heart Journal ◽

10.1093/ehjci/ehaa946.3000 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

G Benetos ◽

S Galanakos ◽

I Koutagiar ◽

I Skoumas ◽

G Oikonomou ◽

...

Keyword(s):

Carotid Artery ◽

Statin Therapy ◽

Intima Media Thickness ◽

Carotid Bifurcation ◽

Carotid Intima Media Thickness ◽

Control Group ◽

Carotid Wall ◽

The Impact ◽

Maximum Minimum

Abstract Background Familial hypercholesterolemia (FH) syndromes constitute an important risk factor for premature atherosclerosis. Microwave radiometry (MWR) assess non-invasively carotid artery temperatures reflecting inflammation. Recent data support that statin therapy, that constitutes the cornerstone for the treatment of FH, reduces systemic inflammation. Purpose To investigate the impact of statin therapy either with simvastatin or with combination simvastatin plus ezetimibe on carotid artery temperatures. Methods Consecutive patients with diagnosis of either heterozygous hypercholesterolemia (hFH) or combined hyperlipidemia (FCH) not under statin therapy for at least 6 months were included in the study. FH pts were assigned to either simvastatin 40 mg or simvastatin 40 mg plus ezetimibe 10mg according to the discretion of the physician. FH patients who refused statin therapy were used as control group for the assessment of statins effect. In all subjects, common carotid intima-media thickness (ccIMT) was measured in the last 2 cm of the far wall of both common carotids close to the carotid bifurcation and ΔT (maximum-minimum) temperature measurements were performed across each carotid during MWR evaluation. Examinations were performed at baseline and after 6 months. Blood's lipid profile was also obtained in all patients. Results In total 115 patients were included in the study. Of them 40 patients received simvastatin (19 hFH and 11 FCH), 41 simvastatin + ezetimibe (31hFH and 10 FCH) and 34 (21 hFH and 13 FCH) no statin. There was no difference at baseline in ccIMT and ΔT measurements between hFH and FCH patients (0.10±0.03 vs 0.10±0.02, p=0.74 and 0.88±0.38 vs 0.84±0.32, p=0.52, respectively). Patients who refused statin therapy did not show any reduction in ccIMT and ΔT measurements between baseline and follow up (ccIMT: 0.10±0.02 vs 0.09±0.02, p=0.06 and ΔT: 0.72±0.26 vs 0.70±0.26). In contrast, there was a significant reduction in ccIMT and ΔT for patients under both simvastatin (0.10±0.03 vs 0.09±0.01, p=0.004 for ccIMT and 0.83±0.34 vs 0.63±0.24, p=0.04 for ΔT) and simvastatin + ezetimibe therapy (0.11±0.03 vs 0.09±0.02, p<0.001 and 1.00±0.38 vs 0.69±0.23, p<0.001 for ΔT). Patients under combination therapy reduced more significantly their carotid artery temperatures compared to patients under simvastatin monotherapy or patients without statin (−0.31±0.46 vs −0.2±0.40 vs −0.01±0.37, ANOVA p=0.04, Figure 1). Conclusions Both simvastatin and simvastatin + ezetimibe therapy among the beneficial effect on IMT, reduced carotid wall inflammation in FH pts. Figure 1 Funding Acknowledgement Type of funding source: None

Download Full-text

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

Revista de Chimie ◽

10.37358/rc.18.6.6366 ◽

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.

Download Full-text

Evaluation of the relationship between hepatic and cardiac iron overload with MRI T2* and carotid intima media thickness with Doppler ultrasound in beta thalassemia major patients

Iranian Journal of Pediatric Hematology & Oncology ◽

10.18502/ijpho.v11i1.5005 ◽

2020 ◽

Author(s):

Reihaneh Mortazavi Ardestani ◽

Masoud M. Ardestani

Keyword(s):

Carotid Artery ◽

Iron Overload ◽

Doppler Ultrasound ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Beta Thalassemia ◽

Control Group ◽

Cardiac Iron ◽

Cardiac Iron Overload ◽

The Relationship

Background: Iron overload is caused early progression of atherosclerosis in beta thalassemia patients due to regular repeated blood transfusion. MRI T2* is a gold standard non-invasive method for detecting hepatic and cardiac iron overload. The aim of this study was the comparison of carotid intima media thickness (CIMT) in the patients and healthy control groups with Doppler ultrasound for early diagnosis of atherogenesis. Another purpose was to assess the relationship between CIMT and iron overload among patients. Materials and methods: This cross-sectional study was performed on twenty patients referred to the Sarvar clinic and twenty age- and sex-matched control group. The CIMT was measured with Color Doppler ultrasound in both groups. Then, MRI T2* results, demographic, and therapeutic information were extracted from their documents. Results: CIMT was insignificantly higher in the patients compared to the control group. For example, it was 0.49 ± 0.05 vs. 0.45 ± 0.03 (p = 0.009) for the right common carotid artery (RCCA) and 0.48 ± 0.06 vs. 0.46 ± 0.04 (p = 0.17) for the left common carotid artery (LCCA). There was no strong relationship between CIMT and age (p = 0.09 for RCCA, p = 0.00 for LCCA), sex, chelation type (for example, p = 0.51 for RCCA with Desferal and p = 0.91 for LCCA with Desferal), age at diagnosis, age at the beginning on transfusion (p = 0.49 for RCCA, p = 0.20 for LCCA), age at the start of chelator (p = 0.74 for RCCA, p = 0.78 for LCCA), and hepatic and cardiac iron overload. Conclusion: Preventive and curative methods should be planned to cease its progression. Furthermore, early initiation of chelator drugs with better efficacy and compliance may reverse the hepatotoxic and adverse myocardial effects of excessive iron.

Download Full-text

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

Journal of Lipids ◽

10.1155/2014/546863 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Arvind Vijayasarathi ◽

Stanley J. Goldberg

Keyword(s):

Metabolic Syndrome ◽

Pediatric Patients ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Significant Negative Correlation ◽

Control Group ◽

Patients Âgés ◽

Carotid Intimal Medial Thickness ◽

Age Range ◽

Familial Hyperlipidemia

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.

Download Full-text

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

Romanian Journal of Internal Medicine ◽

10.2478/rjim-2021-0028 ◽

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.

Download Full-text

Endothelial Dysfunction and Inflammatory Markers of Vascular Disease

Current Vascular Pharmacology ◽

10.2174/1570161118666200421142542 ◽

2020 ◽

Vol 19 (3) ◽

pp. 243-249 ◽

Cited By ~ 1

Author(s):

Sevket Balta

Keyword(s):

Endothelial Dysfunction ◽

Vascular Disease ◽

Inflammatory Markers ◽

Vascular Diseases ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Non Invasive ◽

Von Willebrand ◽

The Relationship ◽

Willebrand Factor

: Vascular diseases are the main reason for morbidity and mortality worldwide. As we know, the earlier phase of vascular diseases is endothelial dysfunction in humans, the endothelial tissues play an important role in inflammation, coagulation, and angiogenesis, via organizing ligand-receptor associations and the various mediators’ secretion. We can use many inflammatory non-invasive tests (flowmediated dilatation, epicedial fat thickness, carotid-intima media thickness, arterial stiffness and anklebrachial index) for assessing the endothelial function. In addition, many biomarkers (ischemia modified albumin, pentraxin-3, E-selectin, angiopoietin, endothelial cell specific molecule 1, asymmetrical dimethylarginine, von Willebrand factor, endothelial microparticles and endothelial progenitor cells) can be used to evaluate endothelial dysfunction. We have focused on the relationship between endothelial dysfunction and inflammatory markers of vascular disease in this review.

Download Full-text

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

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211026993 ◽

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.

Download Full-text

Sirtuin 1, Visfatin and IL-27 Serum Levels of Type 1 Diabetic Females in Relation to Cardiovascular Parameters and Autoimmune Thyroid Disease

Biomolecules ◽

10.3390/biom11081110 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1110

Author(s):

Magdalena Łukawska-Tatarczuk ◽

Edward Franek ◽

Leszek Czupryniak ◽

Ilona Joniec-Maciejak ◽

Agnieszka Pawlak ◽

...

Keyword(s):

Global Longitudinal Strain ◽

Thyroid Volume ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Left Ventricular ◽

Sirtuin 1 ◽

Control Group ◽

Cardiovascular Parameters ◽

Autoimmune Thyroid

The loss of cardioprotection observed in premenopausal, diabetic women may result from the interplay between epigenetic, metabolic, and immunological factors. The aim of this study was to evaluate the concentration of sirtuin 1, visfatin, and IL-27 in relation to cardiovascular parameters and Hashimoto’s disease (HD) in young, asymptomatic women with type 1 diabetes mellitus (T1DM). Thyroid ultrasound, carotid intima-media thickness (cIMT) measurement, electrocardiography, and echocardiography were performed in 50 euthyroid females with T1DM (28 with HD and 22 without concomitant diseases) and 30 controls. The concentrations of serum sirtuin 1, visfatin and IL-27 were assessed using ELISA. The T1DM and HD group had higher cIMT (p = 0.018) and lower left ventricular global longitudinal strain (p = 0.025) compared to females with T1DM exclusively. In women with a double diagnosis, the sirtuin 1 and IL-27 concentrations were non-significantly higher than in other groups and significantly positively correlated with each other (r = 0.445, p = 0.018) and thyroid volume (r = 0.511, p = 0.005; r = 0.482, p = 0.009, respectively) and negatively correlated with relative wall thickness (r = –0.451, p = 0.016; r = –0.387, p = 0.041, respectively). These relationships were not observed in the control group nor for the visfatin concentration. These results suggest that sirtuin 1 and IL-27 contribute to the pathogenesis of early cardiac dysfunction in women with T1DM and HD.

Download Full-text