The Clinical Significance of Separate Measurements of Carotid Arterial Wall to Assess the Risk Factor for Atherosclerosis
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. Methods: Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary’s Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). Results: In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. Conclusion: We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.
Abstract
Background: Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. Methods: Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary’s Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). Results: In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. Conclusion: We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.
참고문헌 (22)
- Polak JF, "Carotid-wall intima-media thickness and cardiovascular events", N Engl J Med, 365, pp.213~221 (2011)
- Finn AV, "Correlation between carotid intimal", medial thickness and atherosclerosis: a point of view from pathology, 2010, pp.30, 177~181
- Nguyen-Thanh HT, "Screening for subclinical coronary artery disease measuring carotid intima media thickness", Am J Cardiol, 104, pp.1383~1388 (2009)
- Choi YS, "Measurement of the intimal thickness of the carotid artery: comparison between 40MHz ultrasound and histology in rats", Ultrasound Med Biol, 35, pp.962~966 (2009)
- Pignoli P, "Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging", Circulation, 74, pp.1399~1406 (1986)
- Johnson HM, "Predictors of carotid intima-media thickness progression in young adults: the Bogalusa Heart Study", Stroke, 38, pp.900~905 (2007)
- Koskinen J, "Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation", Circulation, 120, pp.229~236 (2009)
- Tzou WS, "Increased subclinical atherosclerosis in young adults with metabolic syndrome: the Bogalusa Heart Study", J Am Coll Cardiol, 46, pp.457~463 (2005)
- Mattsson N, "Arterial structure and function in young adults with the metabolic syndrome: the Cardiovascular Risk in Young Finns Study", Eur Heart J, 29, pp.784~791 (2008)
- Bae JH, "Individual measurement and significance of carotid intima, media, and intima-media thickness by Bmode ultrasonographic image processing", Arterioscler Thromb Vasc Biol, 26, pp.2380~2385 (2006)
- Semba I, "Histomorphometric analysis of age changes in the human inferior alveolar artery", Arch Oral Biol, 46, pp.13~21 (2001)
- 원희관, "고혈압 환자의 경동맥 내중막 두께의 증가는 중막 두께의 증가에 기인한다", 대한내과학회지, 75(2), pp.179~185 (2008), 대한내과학회
- Gussenhoven EJ, "Assessment of medial thinning in atherosclerosis by intravascular ultrasound", Am J Cardiol, 68, pp.1625~1632 (1991)
- Stein JH, "Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine", J Am Soc Echocardiogr, 21, pp.93~111 (2008)
- Iannuzzi A, "Carotid artery remodeling in middle-aged women with the metabolic syndrome (from the “Progetto ATENA”study)", Am J Cardiol, 96, pp.1162~1165 (2005)
- Kim G, "The clinical usefulness of central hemodynamics to evaluate diastolic dysfunction in subjects without hypertension", Clin Interv Aging, 9, pp.527~533 (2014)
- Okumura K, "Multivessel coronary spasm in patients with variant angina: a study with intracoronary injection of acetylcholine", Circulation, 77, pp.535~542 (1988)
- McMahan CA, "Association of Pathobiologic Determinants of Atherosclerosis in Youth risk score and 15-year change in risk score with carotid artery intima-media thickness in young adults (from the Cardiovascular Risk in Young Finns Study)", Am J Cardiol, 100, pp.1124~1129 (2007)
- Nakashima Y, "Distributions of diffuse intimal thickening in human arteries: preferential expression in athero-sclerosis-prone arteries from an early age", Virchows Arch, 441, pp.279~288 (2002)
- Roman MJ, "Clinical application of noninvasive vascular ultrasound in cardiovascular risk stratification: a report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology", J Am Soc Echocardiog, 19, pp.943~954 (2006)
- Rodriguez-Macias KA, "Thicker carotid intima layer and thinner media layer in subjects with cardiovascular diseases. An investigation using noninvasive high-frequency ultrasound", Atherosclerosis, 189, pp.393~400 (2006)
- Urbina EM, "Impact of multiple coronary risk factors on the intima-media thickness of different segments of carotid artery in healthy young adults (The Bogalusa Heart Study)", Am J Cardiol, 90, pp.953~958 (2002)