Research Article
BibTex RIS Cite

Kardiyovasküler risk faktörü olan hastalarda ana karotid, internal karotid, brakiyal, femoral arterler ve abdominal aorta intima-media kalınlığının B-Mod ultrasonografi ile değerlendirilmesi

Year 2018, Volume: 2 Issue: 3, 244 - 248, 01.09.2018
https://doi.org/10.28982/josam.421768

Abstract

Amaç: Bu çalışmada, farklı anatomik bölgelerden ölçülen intima-media kalınlığı (IMT) ile ana karotid IMT arasındaki ilişkiyi değerlendirmeyi amaçladık.

Yöntemler: 256 hasta prospektif olarak incelendi. B-mod ultrasound ile ana karotid, internal karotid, brakiyal ve femoral arter ile abdominal aort IMT değerleri ölçüldü (CC-IMT, IC-IMT, B-IMT, F-IMT ve A-IMT). Hastalar normal ve artmış CC- IMT değerlerine göre iki gruba ayrıldı. 

Bulgular: 256 hastanın 55’inde (%21,5) artmış CC-IMT tespit edildi. Tüm IMT değerleri CC-IMT ile pozitif olarak korelasyon göstermekteydi. Femoral IMT bağımsız olarak artmış CC-IMT ile ilişkiliydi. Regresyon analizine göre F-IMT'deki her 0,1 mm'lik artış, artmış CC-IMT riskini % 70,2 artırmaktaydı. F-IMT cut-off değeri 1,1 mm olarak kabul edildiğinde artmış CC-IMT varlığını %96,4 duyarlılık ve %90 özgüllük ile tespit etmekteydi. ROC eğri analizinde, eğri altında kalan alan değeri 0,936 olarak ölçüldü.

Sonuç: Artmış CC-IMT’i en iyi belirleyen diğer IMT bölgesi F-IMT olduğu bulundu. Klinik pratikte F-IMT sınır değeri olarak >1,1 mm kullanılabilir. CC-IMT ölçümü tüm diğer vasküler IMT ölçümü ile yakın ve pozitif olarak ilişkilidir.

References

  • 1. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013 Jul;34(28):2159-219.
  • 2. Belhassen L, Carville C, Pelle G, Monin JL, Teiger E, Duval-Moulin AM, et al. Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valve surgery. J Am Coll Cardiol. 2002;39:1139-44.
  • 3. Handa N, Matsumoto M, Maeda H, Hougaku H, Ogawa S, Fukunaga R, et al. Ultrasonic evaluation of early carotid atherosclerosis. Stroke. 1990;21:1567–72.
  • 4. Heiss G, Sharrett AR, Barnes R, Chambless LE, Szklo M, Alzola C. Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC study. Am J Epidemiol. 1991;134:250–6.
  • 5. Wofford JL, Kahl FR, Howard GR, McKinney WM, Toole JF, Crouse JR 3rd. Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis. Arterioscler Thromb. 1991;11:1786–94.
  • 6. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK, Jr., the Cardiovascular Health Study Collaborative Research Group. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med. 1999;340:14–22.
  • 7. Sartorato P, Zulian E, Benedini S, Mariniello B, Schiavi F, Bilora F, et al. Cardiovascular risk factors and ultrasound evaluation of intima-media thickness at common carotids, carotid bulbs, and femoral and abdominal aorta arteries in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab. 2007;92:1015-8.
  • 8. Belhassen L, Carville C, Pelle G, Monin JL, Teiger E, Duval-Moulin AM, et al. Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valve surgery. J Am Coll Cardiol. 2002;39:1139-44.
  • 9. Kallizaros JE, Tsioufis CP, Stefanadis CI, Pitsavos CE, Toutouzas PK. Close relation between carotid and ascending aortic atherosclerosis in cardiac patients. Circulation. 2000;102:263–8.
  • 10. Tomochika Y, Tanaka N, Ono S, Murata K, Muro A, Yamamura T, et al. Assessment by transesophageal echography of atherosclerosis of the descending thoracic aorta in patients with hypercholesterolemia. Am J Cardiol. 1999;83:703–9.
  • 11. Labropoulos N, Zarge J, Mansour MA, Kang SS, Baker WH. Compensatory arterial enlargement is a common pathobiologic response in early atherosclerosis. Am J Surg. 1998;176:140–3.
  • 12. Meena D, Prakash M, Gupta Y, Bhadada SK, Khandelwal N. Carotid, aorta and renal arteries intima-media thickness in patients with sporadic idiopathic hypoparathyroidism. Indian J Endocrinol Metab. 2015;19:262-6.
  • 13. Neiva Neto EC, Piatto MJ, Paschôa AF, Godoy Ide B, Schlaad SW, Van Bellen B. Intima-media thickness: correlation between carotids, vertebral artery, aorta and femoral arteries. Int Angiol. 2015;34:269-75.
  • 14. Lisowska A, Musiał WJ, Knapp M, Prokop J, Dobrzycki S. Carotid and femoral atherosclerotic lesions in patients with coronary heart disease confirmed by angiography. Kardiol Pol. 2005;63:636-42.
  • 15. Iwamoto Y, Maruhashi T, Fujii Y, Idei N, Fujimura N, Mikami S, et al. Intima-media thickness of brachial artery, vascular function, and cardiovascular risk factors. Arterioscler Thromb Vasc Biol. 2012;32:2295-303.
  • 16. Cheng KS, Mikhailidis DP, Hamilton G, Seifalian AM. A review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors. Cardiovasc Res. 2002;54:528-38.
  • 17. Kirhmajer MV, Banfic L, Vojkovic M, Strozzi M, Bulum J, Miovski Z. Correlation of femoral intima-media thickness and the severity of coronary artery disease. Angiology. 2011;62:134-9.
  • 18. Sorensen KE, Kristensen IB, Celermajer DS. Atherosclerosis in the human brachial artery. J Am Coll Cardiol. 1997;29:318-22.
  • 19. Hafner F, Kieninger A, Meinitzer A, Gary T, Froehlich H, Haas E, et al. Endothelial dysfunction and brachial intima-media thickness: long term cardiovascular risk with claudication related to peripheral arterial disease: a prospective analysis. PLoS One. 2014;9:e93357.
  • 20. Agewall S, Henareh L, Jogestrand T. Intima-media complex of both the brachial artery and the common carotid artery are associated with left ventricular hypertrophy in patients with previous myocardial infarction. J Hypertens. 2005;23:119-25.
  • 21. Koyoshi R, Miura S, Kumagai N, Shiga Y, Mitsutake R, Saku K. Clinical significance of flow-mediated dilation, brachial intima-media thickness and pulse wave velocity in patients with and without coronary artery disease. Circ J. 2012;76:1469-75.
  • 22. Kirhmajer MV, Banfic L, Vojkovic M, Strozzi M, Bulum J, Miovski Z. Correlation of femoral intima-media thickness and the severity of coronary artery disease. Angiology. 2011;62:134-9.
  • 23. Lucatelli P, Fagnani C, Tarnoki AD, Tarnoki DL, Stazi MA, Salemi M, et al. Femoral Artery Ultrasound Examination. Angiology. 2017;68:257-65.
  • 24. Depairon M, Tutta P, van Melle G, Hayoz D, Kappenberger L, Darioli R. Reference values of intima-medial thickness of carotid and femoral arteries in subjects aged 20 to 60 years and without cardiovascular risk factors. Arch Mal Coeur Vaiss. 2000;93:721-6.
  • 25. Cheng KS, Mikhailidis DP, Hamilton G, Seifalian AM. A review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors. Cardiovasc Res. 2002;54:528-38.
  • 26. Mita T, Katakami N, Shiraiwa T, Yoshii H, Gosho M, Shimomura I, et al. Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis. Diabetes Ther. 2017;8:1135-46.

B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor

Year 2018, Volume: 2 Issue: 3, 244 - 248, 01.09.2018
https://doi.org/10.28982/josam.421768

Abstract

Aim: The aim of the present study was to assess the association between common carotid intima-media thickness (IMT) and vascular IMT values measured from different anatomic regions.

Methods: We prospectively included 256 patients. The IMT values of the common carotid and internal carotid, brachial and femoral artery and abdominal aorta were measured by B-mode ultrasound (CC-IMT, IC-IMT, B-IMT, F-IMT and A-IMT). Patients were divided into two groups as increased and normal CC-IMT. 

Results: Increased CC-IMT was detected in 55 of 256 patients (21.5%). All IMT variables showed a positive correlation with CC-IMT. Femoral IMT was independently associated with increased CC-IMT. In regression model, each 0.1 mm increase in F-IMT increased the risk of increased CC-IMT by 70.2%. When F-IMT value 1.1 mm was accepted as a cut-off value for the prediction of increased CC-IMT, sensitivity and specificity were 96.4% and 90%, respectively. In ROC curve analyses, the area under curve was calculated as 0.936. 

Conclusions: Another vascular IMT location presenting increased CC-IMT best is F-IMT. The limit value for increased F-IMT >1.1mm may be used in practice. The CC-IMT measurement is closely and positively associated with all other vascular IMT measurements.

References

  • 1. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013 Jul;34(28):2159-219.
  • 2. Belhassen L, Carville C, Pelle G, Monin JL, Teiger E, Duval-Moulin AM, et al. Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valve surgery. J Am Coll Cardiol. 2002;39:1139-44.
  • 3. Handa N, Matsumoto M, Maeda H, Hougaku H, Ogawa S, Fukunaga R, et al. Ultrasonic evaluation of early carotid atherosclerosis. Stroke. 1990;21:1567–72.
  • 4. Heiss G, Sharrett AR, Barnes R, Chambless LE, Szklo M, Alzola C. Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC study. Am J Epidemiol. 1991;134:250–6.
  • 5. Wofford JL, Kahl FR, Howard GR, McKinney WM, Toole JF, Crouse JR 3rd. Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis. Arterioscler Thromb. 1991;11:1786–94.
  • 6. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK, Jr., the Cardiovascular Health Study Collaborative Research Group. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med. 1999;340:14–22.
  • 7. Sartorato P, Zulian E, Benedini S, Mariniello B, Schiavi F, Bilora F, et al. Cardiovascular risk factors and ultrasound evaluation of intima-media thickness at common carotids, carotid bulbs, and femoral and abdominal aorta arteries in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab. 2007;92:1015-8.
  • 8. Belhassen L, Carville C, Pelle G, Monin JL, Teiger E, Duval-Moulin AM, et al. Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valve surgery. J Am Coll Cardiol. 2002;39:1139-44.
  • 9. Kallizaros JE, Tsioufis CP, Stefanadis CI, Pitsavos CE, Toutouzas PK. Close relation between carotid and ascending aortic atherosclerosis in cardiac patients. Circulation. 2000;102:263–8.
  • 10. Tomochika Y, Tanaka N, Ono S, Murata K, Muro A, Yamamura T, et al. Assessment by transesophageal echography of atherosclerosis of the descending thoracic aorta in patients with hypercholesterolemia. Am J Cardiol. 1999;83:703–9.
  • 11. Labropoulos N, Zarge J, Mansour MA, Kang SS, Baker WH. Compensatory arterial enlargement is a common pathobiologic response in early atherosclerosis. Am J Surg. 1998;176:140–3.
  • 12. Meena D, Prakash M, Gupta Y, Bhadada SK, Khandelwal N. Carotid, aorta and renal arteries intima-media thickness in patients with sporadic idiopathic hypoparathyroidism. Indian J Endocrinol Metab. 2015;19:262-6.
  • 13. Neiva Neto EC, Piatto MJ, Paschôa AF, Godoy Ide B, Schlaad SW, Van Bellen B. Intima-media thickness: correlation between carotids, vertebral artery, aorta and femoral arteries. Int Angiol. 2015;34:269-75.
  • 14. Lisowska A, Musiał WJ, Knapp M, Prokop J, Dobrzycki S. Carotid and femoral atherosclerotic lesions in patients with coronary heart disease confirmed by angiography. Kardiol Pol. 2005;63:636-42.
  • 15. Iwamoto Y, Maruhashi T, Fujii Y, Idei N, Fujimura N, Mikami S, et al. Intima-media thickness of brachial artery, vascular function, and cardiovascular risk factors. Arterioscler Thromb Vasc Biol. 2012;32:2295-303.
  • 16. Cheng KS, Mikhailidis DP, Hamilton G, Seifalian AM. A review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors. Cardiovasc Res. 2002;54:528-38.
  • 17. Kirhmajer MV, Banfic L, Vojkovic M, Strozzi M, Bulum J, Miovski Z. Correlation of femoral intima-media thickness and the severity of coronary artery disease. Angiology. 2011;62:134-9.
  • 18. Sorensen KE, Kristensen IB, Celermajer DS. Atherosclerosis in the human brachial artery. J Am Coll Cardiol. 1997;29:318-22.
  • 19. Hafner F, Kieninger A, Meinitzer A, Gary T, Froehlich H, Haas E, et al. Endothelial dysfunction and brachial intima-media thickness: long term cardiovascular risk with claudication related to peripheral arterial disease: a prospective analysis. PLoS One. 2014;9:e93357.
  • 20. Agewall S, Henareh L, Jogestrand T. Intima-media complex of both the brachial artery and the common carotid artery are associated with left ventricular hypertrophy in patients with previous myocardial infarction. J Hypertens. 2005;23:119-25.
  • 21. Koyoshi R, Miura S, Kumagai N, Shiga Y, Mitsutake R, Saku K. Clinical significance of flow-mediated dilation, brachial intima-media thickness and pulse wave velocity in patients with and without coronary artery disease. Circ J. 2012;76:1469-75.
  • 22. Kirhmajer MV, Banfic L, Vojkovic M, Strozzi M, Bulum J, Miovski Z. Correlation of femoral intima-media thickness and the severity of coronary artery disease. Angiology. 2011;62:134-9.
  • 23. Lucatelli P, Fagnani C, Tarnoki AD, Tarnoki DL, Stazi MA, Salemi M, et al. Femoral Artery Ultrasound Examination. Angiology. 2017;68:257-65.
  • 24. Depairon M, Tutta P, van Melle G, Hayoz D, Kappenberger L, Darioli R. Reference values of intima-medial thickness of carotid and femoral arteries in subjects aged 20 to 60 years and without cardiovascular risk factors. Arch Mal Coeur Vaiss. 2000;93:721-6.
  • 25. Cheng KS, Mikhailidis DP, Hamilton G, Seifalian AM. A review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors. Cardiovasc Res. 2002;54:528-38.
  • 26. Mita T, Katakami N, Shiraiwa T, Yoshii H, Gosho M, Shimomura I, et al. Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis. Diabetes Ther. 2017;8:1135-46.
There are 26 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research article
Authors

Ayşe Selcan Koç

Burçak Çakır Peköz

Publication Date September 1, 2018
Published in Issue Year 2018 Volume: 2 Issue: 3

Cite

APA Koç, A. S., & Peköz, B. Ç. (2018). B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor. Journal of Surgery and Medicine, 2(3), 244-248. https://doi.org/10.28982/josam.421768
AMA Koç AS, Peköz BÇ. B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor. J Surg Med. September 2018;2(3):244-248. doi:10.28982/josam.421768
Chicago Koç, Ayşe Selcan, and Burçak Çakır Peköz. “B-Mode Ultrasound Assessment of Intima-Media Thickness of Common Carotid, Internal Carotid, Brachial, Femoral Arteries and Abdominal Aorta in Patients With Cardiovascular Risk Factor”. Journal of Surgery and Medicine 2, no. 3 (September 2018): 244-48. https://doi.org/10.28982/josam.421768.
EndNote Koç AS, Peköz BÇ (September 1, 2018) B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor. Journal of Surgery and Medicine 2 3 244–248.
IEEE A. S. Koç and B. Ç. Peköz, “B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor”, J Surg Med, vol. 2, no. 3, pp. 244–248, 2018, doi: 10.28982/josam.421768.
ISNAD Koç, Ayşe Selcan - Peköz, Burçak Çakır. “B-Mode Ultrasound Assessment of Intima-Media Thickness of Common Carotid, Internal Carotid, Brachial, Femoral Arteries and Abdominal Aorta in Patients With Cardiovascular Risk Factor”. Journal of Surgery and Medicine 2/3 (September 2018), 244-248. https://doi.org/10.28982/josam.421768.
JAMA Koç AS, Peköz BÇ. B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor. J Surg Med. 2018;2:244–248.
MLA Koç, Ayşe Selcan and Burçak Çakır Peköz. “B-Mode Ultrasound Assessment of Intima-Media Thickness of Common Carotid, Internal Carotid, Brachial, Femoral Arteries and Abdominal Aorta in Patients With Cardiovascular Risk Factor”. Journal of Surgery and Medicine, vol. 2, no. 3, 2018, pp. 244-8, doi:10.28982/josam.421768.
Vancouver Koç AS, Peköz BÇ. B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor. J Surg Med. 2018;2(3):244-8.