Clinical Significance of B-Mode Ultrasound of Common Carotid Artery for Prediction of Severity of Coronary Artery Disease: Important Parameters on Hand Measurement

Kim, Ji Hoon; Youn, Ho Joong; Hong, Eunsook; Park, Chul Soo; Lee, Jong Min; Lim, Sang Hyun; Oh, Yong Seok; Chung, Wook Sung; Seung, Ki Bae; Kim, Jae Hyung; Choi, Kyu Bo; Hong, Soon Jo

doi:10.4070/kcj.2005.35.6.467

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…CCA-IMT is a well-established surrogate marker of coronary atherosclerosis [ 26 , 27 ] and is associated with cardiovascular events [ 28 ]. It is efficient, relatively unexpensive and highly reproducible and does not expose patients to contrast dye or radiation.…”

Section: Discussionmentioning

confidence: 99%

Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

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Scicchitano

Zito

et al. 2011

Cardiovasc Ultrasound

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BackgroundIntima-media thickness of the common carotid artery (CCA-IMT) is a validated marker of systemic atherosclerosis process. The aim of this study was to evaluate the association between coronary artery disease (CAD), left ventricular hypertrophy (LVH) and CCA-IMT, assessed by Radio Frequency-Quality Intima Media Thickness (RFQIMT) method, the next generation of IMT real-time measurement, based on the direct analysis of the radiofrequency signal and endowed with high accuracy and reproducibility in early detection of arterial wall thickness.Methods115 patients (76 men, mean age: 65.1 ± 12 years) referred to our department and shown significant (≥ 70% luminal obstruction) stenosis at least in one major epicardial coronary artery were studied. Coronary angiograms were divided for severity and extent of the disease: 79 patients (69%) had one, 24 patients (21%) two, 12 patients (10%) three major epicardial coronary arteries with ≥ 70% stenosis. All patients underwent echocardiography and carotid ultrasound examination, assessed by RF.ResultsDividing RFQIMT data in tertiles, dyslipidaemia (31 patients with IMT ≥ 1.20 mm vs 16 with IMT = 0.91-1.19 vs 25 with IMT ≤ 0.9, p = 0.004), LVMI (153.5 ± 20.6 g/m2 in IMT ≥ 1.20 mm vs 131.2 ± 8.4 g/m2 in IMT = 0.91-1.19 mm vs 114.3 ± 11.1 g/m2 in IMT ≤ 0.9 mm, P < 0.001) and number of high stenosed coronary arteries (IMT ≥ 1.20 mm population more often showed three vessel diseases than IMT ≤ 0.90 mm one, P < 0.001) seemed to be significantly related to CCA-IMT increases. Furthermore, LVMI is positively related to IMT (r = 0.91; P < 0.001). In a multivariate regression model (R2 = 0.88), RFQIMT remained significantly associated with the dyslipidemia (regression coefficient ± standard error [SE]: 0.057 ± 0.023; p = 0.017), LVMI (regression coefficient ± SE: 0.01 ± 0.001; P < 0.0001) and number of damaged coronaries (regression coefficient ± SE: 0.0174 ± 0.028; P < 0.0001).ConclusionsRFQIMT is a sophisticated method for carotid ultrasound evaluation. Its evaluation in patients with at least one important major epicardial coronary vessel stenosis would help the accuracy in the general assessment of the number of coronary lesions in these patients.

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Section: Discussionmentioning

confidence: 99%

Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

Ciccone

Scicchitano

Zito

et al. 2011

Cardiovasc Ultrasound

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“…3 ). 35) 39) However, reliable characterization of plaque tissue content and features suggestive of plaque instability (ulceration, thin fibrous cap) using standard carotid ultrasound techniques is not yet possible. In addition, there is a need for a developing a molecular imaging method that is capable of identifying the echolucent or calcified plaque on carotid ultrasound.…”

Section: The Evaluation Of Carotid Plaquementioning

confidence: 99%

Is Carotid Artery Ultrasound Still Useful Method for Evaluation of Atherosclerosis?

Kim

Youn

2017

Korean Circ J

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Carotid ultrasound is an imaging modality that allows non-invasive assessment of vascular anatomy and function. Carotid intima-media thickness (IMT) has been shown to predict cardiovascular (CV) risk in multiple large studies. However, in 2013, American College of Cardiology/American Heart Association guidelines designated that the carotid IMT as class III evidence level was not recommended for use in clinical practice as a routine measurement of risk assessment for a first atherosclerotic CV event. Following the announcement of this guideline, combined common carotid IMT and plaque, including plaque tissue characterization and plaque burden, using 3D ultrasound was reported to be better than either measurement alone in a variety of studies. Moreover, changes in the intima thickness were related to aging and early atherosclerosis, and remodeling of the media thickness was associated with hypertension. Separate measurement is useful for evaluating the effects of different atherosclerotic risk factors on the arterial wall; however, a more detailed and elaborate technique needs to be developed. If so, separate measurement will play an important role in the assessment of atherosclerosis and arterial wall change according to a variety of risk factors, such as metabolic syndrome. In addition, although carotid blood flow velocity is a useful tool for risk classification and prediction in clinical practice, further clinical research is needed. The value of carotid IMT by ultrasound examination for risk stratification remains controversial, and groups developing future guidelines should consider the roles of plaque presence and burden and hemodynamic parameters in additional risk stratification beyond carotid IMT in clinical practice.

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“… 11 - 13) Several studies have also shown that carotid plaque predicts the presence and extent of coronary artery disease (CAD). 14) 15) …”

Section: Introductionmentioning

confidence: 99%

Prevalence and Significance of Carotid Plaques in Patients With Coronary Atherosclerosis

et al. 2009

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Background and ObjectivesCarotid artery intima-media thickness (CIMT) has recently been recommended as a non-invasive tool for primary prevention of cardiovascular events; the association between CIMT and adverse cardiovascular events is well-known. We sought to evaluate the prevalence and significance of carotid artery plaque, especially in patients with coronary atherosclerosis.Subjects and MethodsThe study population consisted of 1,705 consecutive patients {933 males (54.7%); mean age, 59.7±10.9 years} who underwent coronary angiography and carotid artery scanning using high-resolution ultrasonography. Carotid plaque was defined as a focal structure encroaching into the arterial lumen by at least 50% of the surrounding IMT value or a thickness >1.2 mm.ResultsCarotid plaque was identified in 30.3% (516/1,705) of the patients. Of patients in whom the plaque location could be evaluated (n=1,027), carotid plaque was located at the common carotid artery {n=64/267 (24.0%)}, carotid bulb {n=194/267 (72.7%)}, and at both sites {n=9/267 (3.4%)}. The prevalence of hypertension (58.5% vs. 45.2%, p<0.001) and diabetes mellitus (30.6% vs. 23.5%, p=0.007) was higher in patients with carotid plaques. The patients with carotid plaques were older (65.4±8.9 years vs. 57.2±10.7 years, p<0.0001), had a thicker CIMT (0.89±0.20 mm vs. 0.77±0.16 mm, p<0.001), and higher fasting blood sugar (FBS) levels (132.1±60.7 mg/dL vs. 121.6±47.1 mg/dL, p<0.001) than those without carotid plaque. Patients with carotid plaque more frequently presented with acute coronary syndrome (32.4% vs. 23.9%, p<0.001) than those without carotid plaque. Significant coronary artery stenosis by coronary angiography (75.4% vs. 58.3%, p<0.001), especially multi-vessel disease (46.3% vs. 27.2%, p<0.001), was more frequent in patients with carotid plaques. On multivariate analysis, old age (≥65 years), hypertension, and increased CIMT (≥1.0 mm) were independent predictors of carotid plaque. Carotid plaque (odds ratio, 1.85; 95% confidence interval, 1.39-2.45; p<0.001) was an independent predictor of multivessel disease based on multivariate regression analysis.ConclusionCarotid plaque was common (30.3%) in Korean patients with coronary atherosclerosis, but it is still relatively uncommon compared to Western populations. Carotid plaque was associated with old age, hypertension, and increased IMT, and was an independent predictor of multi-vessel disease.

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Clinical Significance of B-Mode Ultrasound of Common Carotid Artery for Prediction of Severity of Coronary Artery Disease: Important Parameters on Hand Measurement

Cited by 7 publications

References 21 publications

Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

Is Carotid Artery Ultrasound Still Useful Method for Evaluation of Atherosclerosis?

Prevalence and Significance of Carotid Plaques in Patients With Coronary Atherosclerosis

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