Document Detail


Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment.
MedLine Citation:
PMID:  22721828     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Common carotid artery intima-media thickness (IMT), a measure of atherosclerosis, varies between peak systole and end-diastole. This difference might affect cardiovascular risk assessment.
METHODS: IMT measurements of the right and left common carotid arteries were synchronized with an electrocardiogram, using the R wave for end-diastole and the T wave for peak systole. IMT was measured in 2,930 members of the Framingham Offspring Study. Multivariate regression models were generated with end-diastolic IMT, peak systolic IMT, and change in IMT as dependent variables and Framingham risk factors as independent variables. End-diastolic IMT estimates were compared with the upper quartile of IMT on the basis of normative data obtained at peak systole.
RESULTS: The average age of the study population was 57.9 years. The average difference in IMT during the cardiac cycle was 0.037 mm (95% confidence interval, 0.035-0.038 mm). End-diastolic IMT and peak systolic IMT had similar associations with Framingham risk factors (total R(2) = 0.292 vs 0.275) and were significantly associated with all risk factors. In a fully adjusted multivariate model, thinner IMT at peak systole was associated with pulse pressure (P < .0001), low-density lipoprotein cholesterol (P = .0064), age (P = .046), and no other risk factors. Performing end-diastolic IMT measurements while using upper quartile peak systolic IMT normative data led to inappropriately increasing by 42.1% the number of individuals in the fourth IMT quartile (high cardiovascular risk category).
CONCLUSION: The difference in IMT between peak systole and end diastole is associated with pulse pressure, low-density lipoprotein cholesterol, and age. In this study, the mean IMT difference during the cardiac cycle led to an overestimation by 42.1% of individuals at high risk for cardiovascular disease.
Authors:
Joseph F Polak; Allison Meisner; Michael J Pencina; Philip A Wolf; Ralph B D'Agostino
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-06-20
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  25     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-24     Completed Date:  2013-01-08     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1023-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Cardiac-Gated Imaging Techniques / methods*
Carotid Artery, Common / pathology,  ultrasonography*
Carotid Intima-Media Thickness*
Diastole
Echocardiography / methods*
Female
Humans
Male
Middle Aged
Regression Analysis
Risk Assessment
Risk Factors
Systole
Videotape Recording
Grant Support
ID/Acronym/Agency:
HL081352/HL/NHLBI NIH HHS; N01 HC025195/HC/NHLBI NIH HHS; N01-HC-25195/HC/NHLBI NIH HHS; R01 HL069003/HL/NHLBI NIH HHS; R01 HL069003/HL/NHLBI NIH HHS; R01 HL081352/HL/NHLBI NIH HHS; T32 GM074905/GM/NIGMS NIH HHS
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