A non-invasive technique using high-frequency ultrasound brachial artery imaging to assess endothelium-dependent flow-mediated vasodilatation is a widely used test, but interpretation of results is not consistent. This study was designed to assess the method of non-invasive endothelial function determination of a brachial artery. Endothelial function was assessed by two physicians in 18 young, healthy volunteers. Each volunteer was examined by both physicians on the same day using an identical protocol; a second assessment was carried out at an interval of 6-7 days. When comparing arterial dilatation at first and second measurements by one physician, there were no statistically significant differences (first physician: 5.95 +/- 2.93% versus 7.63 +/- 4.3%; P = 0.21; second physician: 4.23 +/- 1.6% versus 4.94 +/- 2.69%; P = 0.22). Further, we found statistically significant differences in artery dilatation when comparing measurements made separately by both physicians on the same day (5.95 +/- 2.93% versus 4.23 +/- 1.6%; P = 0.03, and 7.63 +/- 4.3% versus 4.94 +/- 2.69%; P = 0.003). Our results suggest a large inter-individual variability of measurements within the whole group, if made on the same day and at the same time by two physicians. On the contrary, no significant differences were noted when comparing measurements of the whole group by the one physician at an interval of 1 week. It can be concluded that the degree of brachial artery flow-mediated dilatation is difficult to evaluate on the basis of a predefined cut-off point as a single-measurement screening test.
The subclass of triglyceride-rich lipoproteins -remnant-like particles (RLP) seems to be strong and independent risk factor for cardiovascular disease. We evaluated the role of RLP and other risk factors (RF) with sonographically measured intimamedia thickness of carotid arteries (IMT CCA) in a cohort of Czech population including women defined according to the time after menopause. We investigated relation of IMT CCA to age, weight, central obesity, plasma lipids including remnant-like particles cholesterol (RLP-C) and triglycerides (RLP-TG) in 136 men and 160 women. Using multiple linear regression analysis, significant association between IMT CCA and RLP-C was found in women 1-7 years after menopause. In the whole group of women, only age and fasting blood glucose were independently associated with IMT CCA. In men only age significantly correlated with IMT CCA. Significant decrease of all plasma lipids between 1988 and 1996 in men was detected, while in women significant increase in triglycerides and no change in non-HDL cholesterol was observed. RLP-C was the strongest independent RF for atherosclerosis in postmenopausal women but its association with IMT CCA was limited to several years after menopause. In conclusion, women changing reproductive status could be more sensitive to atherogenic impact of remnant lipoproteins.
At present, the supposed association between venous
thromboembolism and atherosclerosis has yet to be proven.
However, no data are available from patients with
thrombophilias. We evaluated the association between preclinical
atherosclerosis and prevalence of thromboembolic events in
patients with thrombophilias. Presence of preclinical
atherosclerosis in common carotid and femoral arteries measured
by ultrasound was assessed by Belcaro score (based mainly on
the presence of plaques) and by measurements of intima media
thickness in the same location in 109 patients (43 men, mean
age 41.5±13 years) with established thrombophilias. Other
parameters under the study were age, presence of traditional
cardiovascular risk factors, anthropometric and clinical data
including blood pressure measurements and medication. The
differences between patients with (n=47) and without (n=62)
thromboembolic events were assessed by paired t-test and chi
square tests. In patients with a history of venous thromboembolism, body mass index and the prevalence of antihypertensive treatment (AT) were significantly higher than in
patients without history of thromboembolism (BMI: 26.5±5.0 vs.
24.4±3.7 kg/m2 ; p=0.04, AT: 25.5 % vs. 8.1 %; p=0.013). No significant differences between groups were found regarding preclinical atherosclerosis. Overweight and hypertension, but not preclinical atherosclerosis, were more prevalent in patients with
thrombophilias suffering from thromboembolism.
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