Correlation of the Extent and Severity of Atherosclerosis in the Coronary and Cerebral Arteries

Mathur, K. S.; Kashyap, Surekha; Kumar, Vineet

doi:10.1161/01.cir.27.5.929

Cited by 109 publications

(58 citation statements)

References 6 publications

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“…28 " 34 However, in vivo evidence points to the association of atherosclerotic involvement in the two arterial circulations. First, most patients with measurable carotid disease or symptoms of carotid disease die of complications of coronary atherosclerosis, not of stroke.…”

Section: Resultsmentioning

confidence: 99%

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Wofford

Kahl

Howard

et al. 1991

Arterioscler Thromb

281

142

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The extent of carotid artery atherosclerosis as measured by B-mode ultrasound has been shown to be strongly and independently correlated with the presence or absence of coronary atherosclerotic disease (CAD), but no studies to date have used carotid B-mode ultrasound to compare the extent of atherosclerotic disease in the two arterial circulations. We used data from a registry of patients undergoing cardiac catheterization and B-mode ultrasound of the carotid arteries to compare the extent of CAD (number of major coronary vessels with 50% or greater stenosis as judged by a consensus interpretation) with the extent of extracranial carotid atherosclerosis. Four hundred thirty-four patients (234 men, 200 women) greater than 40 years of age were stratified by gender and then divided into quartiles on the basis of a B-mode score that was derived by summing arterial wall thickness at nine sites in the left and nine sites in the right carotid arteries. Evaluation of extent of CAD for the four B-mode quartiles showed that men in the lowest B-mode quartile were over six times more likely to have normal coronary arteries than three-to four-vessel CAD, while men in the highest B-mode quartile were over 10 times more likely to have three-to four-vessel CAD than normal coronary arteries. The findings were similar for women but not as dramatic Gender-specific discriminant function models using traditional risk factors alone or in combination with B-mode score were developed to predict the extent of CAD. Discriminant models containing traditional risk factors alone performed only slightly better than a model that contained only the B-mode score. The addition of the B-mode score to models of traditional risk factors added little to the predictive ability for CAD extent (/Irteriosclerosis and Thrombosis 1991;11:1786-1794) E pidemiological studies have established certain factors (age, male gender, hypertension, dyslipidemia, diabetes, and smoking) as predictors of clinical manifestations of coronary artery disease (CAD).1 -3 These same risk factors have also

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Section: Resultsmentioning

confidence: 99%

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Wofford

Kahl

Howard

et al. 1991

Arterioscler Thromb

281

142

View full text Add to dashboard Cite

show abstract

“…12) On the other hand, autopsy studies have shown a strong correlation between carotid and coronary atherosclerosis and parallel findings were found in several clinical studies. [13][14][15][16][17][18] However, the clinical importance of coexisting CAS in patients with MAC, in terms of its implications on the frequency and severity of CAD, has not been extensively studied. In this study, we investigated how the incidence and extent of CAD are affected by the coexistence of carotid atherosclerosis in patients with MAC as compared to those without.…”

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confidence: 99%

Is Carotid Atherosclerosis More Important in Patients With Mitral Annular Calcification Than in Those Without?

et al. 2004

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SUMMARYIt has been suggested that mitral annular calcification (MAC) may be a manifestation of generalized atherosclerosis. However, how the incidence and extent of coronary artery disease (CAD) are affected by the coexistence of carotid atherosclerosis (CAS) in patients with versus without MAC have not yet been studied.We studied 101 patients with echocardiographic MAC and 52 controls without MAC to investigate the clinical impact of CAS on the frequency and severity (defined as the number of obstructed vessels) of CAD in patients with MAC. Carotid Doppler ultrasonographic examination was performed on all patients before coronary angiography. In patients with both MAC and CAS, the incidences of CAD and multivessel disease (≥ 2 vessel or left main coronary artery disease) were significantly higher than in the control group with CAS alone (91% versus 68%, P = 0.008 and 76% versus 44%, P = 0.004, respectively). On the other hand, among study and control patients without CAS, although the frequencies of CAD and multivessel disease were higher in patients with MAC, interestingly, the differences were not statistically significant (37% versus 58% and 15% versus 26%, respectively, P > 0.05 for both). Stepwise multiple logistic regression analysis revealed that CAS (P < 0.001), MAC (P < 0.01) and, to a limited extent hypertension (P = 0.054), were independent predictors for the presence of CAD.In conclusion, the coexistence of CAS is more important in patients with MAC than in those without as it provides valuable information about the incidence and severity of underlying CAD. In cases with MAC but without CAS, MAC could be caused by factors other than atherosclerosis. (Jpn Heart J 2004; 45: 603-611)

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“…1,2) Since arteriosclerosis may affect the aorta and coronary arteries simultaneously, 3) it has been shown that aortic stiffness and distensibility may be markers of coronary events. 4,5) It is inevitable that the arterial pulse is affected by the changes in aortic stiffness and distensibility.…”

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confidence: 99%

<b>Color Doppler Tissue Imaging in Assessing the Elastic Properties of the Aorta and in Predicting Coronary Artery Disease</b>

et al. 2002

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SUMMARYWe hypothesized that the change in aortic elastic properties could directly be shown with color Doppler tissue imaging (CDTI), that these findings could be related to aortic stiffness and distensibility and that, through these, coronary artery disease (CAD) could be predicted.One hundred and twenty six patients (group I: 83 with CAD, mean age 54±10 years, 18 female, 65 male; group II: 43 without CAD, mean age 53±10 years, 27 female, 16 male) having been evaluated for coronary artery disease by angiography were examined by echocardiography. Arterial pressure was measured immediately before echocardiographic evaluation. Internal aortic systolic and diastolic diameters by M-mode echocardiography and aortic upper wall tissue velocities (Aortic S, E, A, m/sec) by CDTI were measured 3 cm above the aortic valve. Lateral mitral annulus tissue velocities (Annulus S, E, A, m/sec) were also recorded. Aortic distensibility (cm 2 •dynes -1 ) and aortic stiffness index were calculated using formulas. In the statistical analyses, CAD risk factors and left ventricular ejection fraction were used for adjustment.Aortic stiffness (2.79±3.49 vs 1.62±1.31, P=0.03), distensibility (1.55±1.46 vs 2.37±3.08, P=0.04), and aortic S velocity (0.057±0.016 vs 0.064±0.015, P=0.02) differed significantly between groups I and II. After adjustment, while aortic stiffness and S velocity were still statistically different (P=0.04; P=0.03 respectively), the significance of the difference in aortic distensibility disappeared (P=0.051). Aortic stiffness and aortic S velocity (0.06 m/sec<) were important CAD determinants (Odds ratio=1.4 P=0.03; Odds ratio=3.6 P=0.01, respectively), but aortic distensibility was not. Aortic stiffness was correlated only with aortic S velocity (r=-0.28, P=0.01), and aortic distensibility had a significantly positive correlation with aortic S velocity (r= 0.20, P=0.02). The interobserver and intraobserver correlation coefficients for aortic S velocities were 0.65 and 0.71, respectively (P<0.05).Elastic properties of the aorta can directly be assessed by reproducibly measuring the movements in the upper wall of the aorta by CDTI. Reduced aortic S velocity is associFrom the

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Correlation of the Extent and Severity of Atherosclerosis in the Coronary and Cerebral Arteries

Cited by 109 publications

References 6 publications

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Is Carotid Atherosclerosis More Important in Patients With Mitral Annular Calcification Than in Those Without?

<b>Color Doppler Tissue Imaging in Assessing the Elastic Properties of the Aorta and in Predicting Coronary Artery Disease</b>

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