| Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment. | |
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MedLine Citation:
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PMID: 22721828 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Joseph F Polak; Allison Meisner; Michael J Pencina; Philip A Wolf; Ralph B D'Agostino |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2012-06-20 |
Journal Detail:
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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:
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Created Date: 2012-08-24 Completed Date: 2013-01-08 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 8801388 Medline TA: J Am Soc Echocardiogr Country: United States |
Other Details:
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Languages: eng Pagination: 1023-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Tufts Medical Center, Department of Radiology, 800 Washington Street, Box 299, Boston, MA 02111, USA. jpolak@tuftsmedicalcenter.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac-Gated Imaging Techniques
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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:
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HL081352/HL/NHLBI NIH HHS; N01 HC025195/HC/NHLBI NIH HHS; N01-HC-25195/HC/NHLBI NIH HHS; R01 HL069003/HL/NHLBI NIH HHS |
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