Levels of agreement in the measurements of carotid artery ultrasound across a regional vascular network

McKenna, Mervyn Alexander; Bonfield, M; Robinson, T.M.

doi:10.1177/1742271x17751255

Cited by 4 publications

(6 citation statements)

References 18 publications

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“…Moreover, we found that the significance of this association increased as a function of the number of carotid plaques analyzed by ultrasound, and we also provide a specific set of proteins that were associated with diffuse atherosclerosis (3+ plaques). Indeed, we identified 87 proteins, which associated with the presence of three or more plaques, presenting either a reduced (5) or increased (82) plasmatic expression compared to controls. By contrast, plasma proteomics was not able to significantly discriminate neither the subjects presenting with 2 or with just one carotid plaque.…”

Section: Discussionmentioning

confidence: 99%

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Plasma proteins identify increased number of carotid plaques and predict occurring atherosclerotic events

Baragetti,

Grigore,

Olmastroni

et al. 2023

Preprint

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BackgroundThe number of carotid plaques independently predicts incident atherosclerotic cardiovascular disease (ACVD).However, performing vascular imaging in apparently healthy subjects is challenging, owing organizational/economical barriers. Plasma proteomics can offer an alternative approach to identify individuals with carotid plaques, at high risk of eventually developing ACVD.MethodsIn this observational study, we studied by Normalized Protein eXpression (NPX; OlinkTM), the plasma levels of 368 proteins in 664 subjects from the PLIC study, who were screened by ultrasound for the presence of carotid plaques. We clustered, by artificial intelligence, the proteins that more accurately identified subjects, stratifying them according to the number of plaques they presented with. We also study prediction of occurring events over 22 years.Results299/664 subjects had at least 1 carotid plaque. Among those, 77 subjects presented with only one plaque, 101 with 2 plaques and 121 with ≥3 plaques (3+). The remaining 365 subjects with no plaques acted as controls. The proteins differently expressed versus controls increased as a function of the number of plaques. 32 proteins were shared among the groups of subjects with plaques, but 87, significantly associated with the presence of 3+ plaques, improved the AUC of the ROC, together with the ACVD risk factors, to discriminate subjects with 3+ plaques versus the AUC of the ROC considering the ACVD risk factors only (AUC= 0.918 (0.887-0.943) vs AUC= 0.760 (0.716-0.801) respectively, p<0.001). The ACVD risk factors barely predicted the 198 occurring events (AUC= 0.559 (0.521-0.598)), but proteomics associated with plaques improved the prediction (AUC= 0.739 (0.704-0.773), p<0.001).By analyzing the biological processes, we identified that chemotaxis/migration of leukocytes and the signaling of interleukins/cytokines were the top pathways involved.ConclusionsPlasma proteomics helps to identify apparently healthy subjects with higher number of carotid plaques more accurately and to predict occurring ACVDs in those individuals.

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Section: Discussionmentioning

confidence: 99%

“…However, applying noninvasive vascular imaging procedures to detect subclinical ACVD, such as those identifying carotid plaques, is challenging in “apparently healthy” population, owing organizational, economical barriers, and given the substantial shortcomings in sensitivity and inter-operator variability 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Plasma proteins identify increased number of carotid plaques and predict occurring atherosclerotic events

Baragetti,

Grigore,

Olmastroni

et al. 2023

Preprint

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“…According to Loizou et al (2015), people who have not undergone cardiovascular changes do not present differences between left and right IMT. Atherosclerotic plaques deposited in the common carotid arteries are not as frequent in animals as they are in humans, where considered one of major causes of mortality in the world (Mendis et al 2011, Ricotta et al 2011, Barlinn et al 2018, Boyko et al 2018, Evans et al 2018, Mckenna et al 2018, Oglat et al 2018.…”

Section: Discussionmentioning

confidence: 99%

“…Doppler ultrasonography is a tool combined with B-mode ultrasonography that allows the hemodynamic evaluation of the vessels (Loizou 2014, Barlinn et al 2018, Boyko et al 2018, Mckenna et al 2018, Oglat et al 2018. The common carotid artery originates three important arteries in horses and mules: the internal carotid artery, the external carotid artery and the occipital artery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of right and left common carotid arteries of horses and mules by two-dimensional ultrasound and Doppler flow

et al. 2020

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In ultrasonography, the bi-dimensional mode (B-mode) allows the morphological and morphometric evaluation of several types of organs and tissues, while the Doppler mode allows the hemodynamic evaluation. In humans, the Doppler evaluation is routinely used in the assessment of important arteries and veins, such as the carotid arteries and jugular veins, with significant differences between genres and sides. However, in veterinary medicine, this diagnostic method is not yet well established in the evaluation of the carotid arteries, with only few reports in domestic horses. This study aims to compare the right and left common carotid arteries of domestic horses and mules using bi-dimensional and Doppler ultrasound evaluation. The common carotid arteries from 10 domestic horses (five males and five females) and 10 mules (five males and five females) were evaluated. The following variables were measured at three different portions (cranial, middle and caudal): diameter, intima-media thickness (IMT), resistivity index (RI), pulsatility index (PI), peak of systolic velocity (pSV) and final diastolic velocity (fDV). No significant differences were observed in the bi-dimensional variables (diameter and IMT) between the common carotid arteries of horses and mules, regardless of gender (p>0.05). In Doppler mode, there were no significant differences between carotid values in male and female horses (p> 0.05). In the mules, it was only possible to observe differences between the RI and PI values (p<0.05), being higher on the left side (0.81 and 2.04 respectively), and the fDV (p<0.05) higher, on the right side (14.35) in males. As for females, there was only in fDV (p<0.05), with the upper right side (23.16). Diameters and IMT do not differ between sides in horses and mules in B-mode ultrasound. Spectral Doppler in horses does not differ between sides, regardless of gender. As for mules, males differ in RI, PI and fDV between sides, while females differ only in fDV.

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“…There is substantial variability from laboratory to laboratory in the CDUS thresholds and derived indices applied to diagnose and grade CS (56)(57)(58)(59)(60). Even among accredited vascular testing centers, the diagnostic thresholds for CS severity vary considerably (60).…”

Section: Diagnostic Criteria For Extracranial Carotid Artery Stenosismentioning

confidence: 99%

Why are we still debating criteria for carotid artery stenosis?

Brutto¹,

Gornik²,

Rundek³

2020

Ann Transl Med

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The risk of new or recurrent stroke is high among patients with extracranial carotid artery stenosis and the benefit of carotid revascularization is associated to the degree of luminal stenosis. Catheterbased digital subtraction angiography (DSA) as the diagnostic gold-standard for carotid stenosis (CS) has been replaced by non-invasive techniques including duplex ultrasound, computed-tomography angiography, and magnetic resonance angiography (MRA). Duplex ultrasound is the primary noninvasive diagnostic tool for detecting, grading and monitoring of carotid artery stenosis due to its low cost, high resolution, and widespread availability. However, as discussed in this review, there is a wide range of practice patterns in use of ultrasound diagnostic criteria for carotid artery stenosis. To date, there is no internationally accepted standard for the gradation of CS. Discrepancies in ultrasound criteria may result in clinically relevant misclassification of disease severity leading to inappropriate referral, or lack of it, to revascularization procedures, and potential for consequential adverse outcome. The Society of Radiologists in Ultrasound (SRU), either as originally outlined or in a modified form, are the most common criteria applied. However, such criteria have received criticism for relying primarily on peak systolic velocities, a parameter that when used in isolation could be misleading. Recent proposals rely on a multiparametric approach in which the hemodynamic consequences of carotid narrowing beyond velocity augmentation are considered for an accurate stenosis classification. Consensus criteria would provide standardized parameters for the diagnosis of CS and considerably improve quality of care. Accrediting bodies around the world have called for consensus on unified criteria for diagnosis of CS. A healthy debate between professionals caring for patients with CS regarding optimal CS criteria still continues.

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Levels of agreement in the measurements of carotid artery ultrasound across a regional vascular network

Cited by 4 publications

References 18 publications

Plasma proteins identify increased number of carotid plaques and predict occurring atherosclerotic events

Plasma proteins identify increased number of carotid plaques and predict occurring atherosclerotic events

Comparison of right and left common carotid arteries of horses and mules by two-dimensional ultrasound and Doppler flow

Why are we still debating criteria for carotid artery stenosis?

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