Arterial wall thickness in familial hypercholesterolemia. Ultrasound measurement of intima-media thickness in the common carotid artery.

Abstract

B-mode ultrasound was used to noninvasively determine wall thickness and lumen diameter in the common carotid artery in patients with familial hypercholesterolemia (n=53) and in a control group (n=53). The controls were matched for sex, age, height, and weight, and all had a serum cholesterol level below 6.5 mmol/1. The study was performed to evaluate whether the patients had a thicker arterial wall compared with that of the control group. Wall thickness was determined as the combined intima-media thickness of the far wall and is presented as the mean and maximum thickness of a 10-mm-long section of the common carotid artery. The difference between the groups was 0.13 mm in mean wall thickness (p<0.001; 95% confidence interval, 0.07-0.18 mm) and 0.20 mm in maximum wall thickness (p<0.001; 95% confidence interval, 0.09-023 mm). Fifty of the subjects were examined twice to estimate the interobserver variability. The coefficients of variation for mean and maximum wall thickness were 102% and 8.9%, respectively. The two study groups were well matched and differed only in lipid levels. Thus, there is reason to believe that the difference in wall thickness can be explained by the background of familial hypercholesterolemia and the increased cholesterol levels. {Arteriosclerosis and Thrombosis 1992; 12:70-77)

Carotid Intimal-Medial Thickness and Stiffness Are Not Affected by Hypercholesterolemia in Uncomplicated Essential Hypertension

“…Nevertheless, although Poli et al 42 detected a significant increase in IMT in their hypercholesterolemic group, there was no significant correlation between carotid IMT and plasma cholesterol levels. In contrast, in the population described by Wendelhag et al, 19 the distribution of IMT in hypercholesterolemic patients appeared to be similar to that in normocholesterolemic subjects except for a few subjects in whom IMT values suggested the inclusion of plaques in the calculation. In addition, studies conducted in normotensive children with familial hypercholesterolemia and very high cholesterol levels showed only modest associations between carotid IMT and cholesterol levels.…”

“…These data are partially in contrast with previous reports that indicated a role of hypercholesterolemia in inducing carotid intimal-medial thickening. 12,19,40 -44 However, 2 of these studies 19,42 included hypercholesterolemic patients with mild or moderate hypertension; moreover, diabetic patients and/or subjects with signs or symptoms of cardiovascular disease were not excluded. Nevertheless, although Poli et al 42 detected a significant increase in IMT in their hypercholesterolemic group, there was no significant correlation between carotid IMT and plasma cholesterol levels.…”

“…[11][12][13][14][15] Moreover, carotid intimalmedial thickening has been described in association with hypertension 16,17 and hypercholesterolemia. 18,19 Studies of hypercholesterolemia have, however, included subjects with mild hypertension and/or symptomatic cardiovascular disease, and thus, they could not assess the independent contributions of uncomplicated hypertension and hypercholesterolemia to intimal-medial thickening.…”

Atherosclerotic changes in the femoral and carotid arteries in familial hypercholesterolemia. Ultrasonographic assessment of intima-media thickness and plaque occurrence.

“…2 -3 An increased thickness of the intima-media complex in the common carotid artery has previously been reported in patients with FH compared with a sex-and age-matched control group. 4 The aim of the present 'Readable recordings had to be available from both the carotid and femoral arteries.…”

“…4 For technical reasons it was not possible to achieve high-quality ultrasound images from both the carotid and femoral arteries in all subjects investigated. The scanning of the femoral artery was somewhat more difficult to perform, partly due to the curved form of the common femoral artery compared with the straight common carotid artery, which explains why more images from the femoral artery were missing compared with the carotid artery.…”