Carotid artery ultrasound texture, cardiovascular risk factors, and subclinical arterial disease: the Multi-Ethnic Study of Atherosclerosis (MESA)

Mitchell, Carol; Korcarz, Claudia E; Tattersall, Matthew C.; Gepner, Adam D.; Young, Rebekah; Post, Wendy S.; Kaufman, Joel D.; McClelland, Robyn L.; Stein, James H.

doi:10.1259/bjr.20170637

Cited by 22 publications

(39 citation statements)

References 35 publications

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“…For example, several authors have described an association between low grayscale median (GSM) values with plaques that are at high risk of rupture and have a large lipid or thrombotic component . Furthermore, anechoic (darker) common carotid artery walls have been associated with cardiovascular disease risk factors such as inflammation, hyperlipidemia, obesity, and circulating measures of oxidative stress; they also predict adverse cardiovascular disease events …”

mentioning

confidence: 99%

Influence of Ultrasound System and Gain on Grayscale Median Values

Steffel

Brown²,

Korcarz

et al. 2018

J of Ultrasound Medicine

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mentioning

confidence: 99%

Influence of Ultrasound System and Gain on Grayscale Median Values

Steffel

Brown²,

Korcarz

et al. 2018

J of Ultrasound Medicine

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“…These measures have not been described previously in the BA, though in the carotid artery, higher levels are associated with lower ASCVD risk and lower levels of ASCVD risk factors. 21,25 Increases in all three grayscale markers correlated with reductions in CD4+ and CD8+ T-cells as well as D-Dimer, a marker of inflammation and coagulation that is associated with increased ASCVD risk and mortality in people with HIV 3,39 and the general population. 40,41 These findings may indicate that the grayscale changes observed in the LDMTX are related to less arterial inflammation.…”

Section: Discussionmentioning

confidence: 95%

“…Resting DICOM images of the proximal BA at end-diastole were converted to bitmaps and normalized by assigning the blackest area of the blood a grayscale value of 0 and the whitest area of the middle two-fourths of the adventitia a grayscale value of 190, then were standardized to a uniform pixel density of 20/mm using LifeQ Medical Software (Nicosia, Cyprus). 24,25,31,35 A reproducible 10 mm segment of the BA wall that was present in all scans within and between visits was segmented by placing the caliper on the blood-intima and media-adventitia interfaces. From this segmentation process, first order statistics from the image histogram were used to measure GSM (a measure of overall echogenicity of the pixels in the BA far wall) and entropy (a measure of randomness of the pixels in the BA far wall).…”

Section: Methodsmentioning

confidence: 99%

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Brachial Artery Echogenicity and Grayscale Texture Changes in HIV-Infected Individuals Receiving Low-Dose Methotrexate

Stein

Yeh

Weber

et al. 2018

ATVB

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Objective We evaluated the biological effects of low-dose methotrexate (LDMTX) on 3 novel brachial artery grayscale ultrasound measures that may indicate subclinical arterial injury. Approach and Results Exploratory analysis from a clinical trial of people with HIV infection at increased cardiovascular disease risk who were randomly assigned to LDMTX (target dose 15 mg/week) or placebo. Brachial artery ultrasound grayscale median, gray level difference statistic texture contrast (GLDS-CON), and gray level texture entropy were measured at baseline and after 24 weeks of intervention. Findings from the intention-to-treat (N=148) and adequately dosed (N=118) populations were consistent, so the adequately dosed population results are presented. Participants were a median (Q1, Q3) age of 54 (50, 60) years. After 24 weeks, the LDMTX intervention was associated with a 25.4% (−18.1, 58.6; p=0.007) increase in GLDS-CON compared to 1.3% (−29.1, 44.7; p=0.97) with placebo (p=0.05) and a 0.10 u (−0.06, 0.23; p=0.026) increase in entropy compared to 0.02 u (−0.11, 0.14; p=0.54) with placebo (p=0.14). At week 24, changes in CD4+ T-cells correlated inversely with changes in GLDS-CON (ρ= −0.20, p=0.031), and entropy (ρ= −0.21, p=0.023). Changes in D-dimer levels, but no other inflammatory biomarkers, also correlated inversely with changes in GLDS-CON (ρ= −0.23, p=0.014) and entropy (ρ= −0.26, p=0.005). Conclusions Brachial artery GLDS-CON and entropy increased after 24 weeks of LDMTX, though the latter was not significantly different from placebo. Grayscale changes were associated with decreases in CD4+ T-cell and D-dimer concentrations and may indicate favorable arterial structure changes.

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“…Grayscale analyses of B-mode images of plaque (if present) were examined for plaque area, grayscale median value, presence of a black area near the border and discrete white areas [50,51]. Grayscale analysis of the right and left distal one centimeter of the common carotid arterial walls was also performed from B-mode images to measure echogenicity (gray scale median value) and evaluate the texture features [52][53][54]. Grayscale analysis was performed with specialized software (LifeQ Medical, Nicosia, Cyprus).…”

Section: Ultrasound Imagingmentioning

confidence: 99%

Protocol of Aerobic Exercise and Cognitive Health (REACH): A Pilot Study

Gaitán

Boots

Dougherty

et al. 2020

ADR

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A growing body of evidence supports that aerobic exercise can decrease the risk of future cognitive impairment and Alzheimer's disease (AD). There is a pressing need to rigorously determine whether cognitively normal yet at-risk individuals stand to benefit from the protective effects of exercise. The present study will test the feasibility of an aerobic exercise intervention in such a population and inform the design of a larger-scale randomized, controlled trial examining the effect of aerobic exercise on biomarkers of AD in late-middle-aged, at-risk individuals. This was a single-site, 1 : 1 block-randomized, parallel, two-arm trial. Cognitively normal participants aged 45-80 with documentation of familial and genetic AD risk factors were randomly assigned to one of two interventions. The Usual Physical Activity group was provided educational materials about exercise. The Enhanced Physical Activity intervention delivered 26 weeks of individualized and supervised aerobic exercise. Exercise duration and intensity were incrementally increased to 150 min/week and 70-80% of heart rate reserve, respectively. Retention and adherence were measured to assess study feasibility. In addition, pre-and postintervention differences between the two arms were evaluated for cardiorespiratory fitness, physical activity, brain glucose

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Carotid artery ultrasound texture, cardiovascular risk factors, and subclinical arterial disease: the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract: These findings support the potential use of the ultrasound texture contrast for evaluating arterial injury and CVD risk. Advances in knowledge: This paper contributes to the literature in that it describes how the greyscale texture feature "contrast" is related to CVD risk factors.

Cited by 22 publications

References 35 publications

Influence of Ultrasound System and Gain on Grayscale Median Values

Influence of Ultrasound System and Gain on Grayscale Median Values

Brachial Artery Echogenicity and Grayscale Texture Changes in HIV-Infected Individuals Receiving Low-Dose Methotrexate

Protocol of Aerobic Exercise and Cognitive Health (REACH): A Pilot Study

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