Reproducibility of Ultrasound Assessment of Carotid Plaque Occurrence, Thickness, and Morphology

Joakimsen, Oddmund; Bønaa, Kaare Harald; Stensland-Bugge, Eva

doi:10.1161/01.str.28.11.2201

Cited by 156 publications

(121 citation statements)

References 33 publications

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“…Some plaques (3%) were defined as unclassifiable because of unsatisfactory imaging quality. 20 The between-and within-sonographer agreement on plaque occurrence was satisfactory, with values of 0.72 (95% CI, 0.60 to 0.84) and 0.76 (95% CI, 0.63 to 0.89), respectively. Agreement on classification of plaque echogenicity was also substantial, with values of 0.73 (95% CI, 0.59 to 0.87) and 0.69 (95% CI, 0.55 to 0.83) between and within sonographers, respectively.…”

Section: Methodsmentioning

confidence: 85%

“…19 Carotid atherosclerosis was assessed by use of high-resolution B-mode ultrasonography performed with an ultrasound scanner (Acuson Xp10 128 ART, upgraded) equipped with a linear-array transducer. 20 A plaque was defined as a localized protrusion of the internal part of the vessel wall into the lumen. Maximum plaque thickness was measured online on frozen B-mode images marked with electronic calipers with measurement readout in 10ths of a millimeter.…”

Section: Methodsmentioning

confidence: 99%

“…Agreement on classification of plaque echogenicity was also substantial, with values of 0.73 (95% CI, 0.59 to 0.87) and 0.69 (95% CI, 0.55 to 0.83) between and within sonographers, respectively. 20 A total of 6727 subjects (77% of the eligible subjects) were examined by ultrasound of the carotid arteries, and in 6164 participants, both HbA 1c measurements and ultrasonography of the carotid artery were performed. In the present study, we excluded persons reporting that they had diabetes and/or used medication for diabetes (nϭ202) and 2 persons with very high readings of HbA 1c but normal nonfasting blood glucose.…”

Section: Methodsmentioning

confidence: 99%

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Glycated Hemoglobin Level Is Strongly Related to the Prevalence of Carotid Artery Plaques With High Echogenicity in Nondiabetic Individuals

et al. 2004

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Background-High levels of HbA 1c have been associated with increased mortality and an increased risk of atherosclerosis assessed as carotid intima-media thickness or plaque prevalence. In the present population-based study, we examined the association between HbA 1c and plaque prevalence with emphasis on plaque echogenicity in subjects not diagnosed with diabetes. Methods and Results-HbA 1c measurements and ultrasonography of the carotid artery were performed in 5960 subjects (3026 women, 2934 men) 25 to 84 years of age. Plaque morphology was categorized into 4 groups from low echogenicity (soft plaque) to strong echogenicity (hard plaque

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Section: Methodsmentioning

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Glycated Hemoglobin Level Is Strongly Related to the Prevalence of Carotid Artery Plaques With High Echogenicity in Nondiabetic Individuals

et al. 2004

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“…The mean intraobserver arithmetic difference (SD) for sonographer 1 was 0.2 (3.1) mm 2 , and the limits of agreement were ±6.1 mm 2 . The corresponding values for sonographer 2 were 0.01 (3.8) and ±7.5 mm 2 [10,15,16].…”

Section: Methodsmentioning

confidence: 86%

Proinsulin:insulin and insulin:glucose ratios as predictors of carotid plaque growth: a population-based 7 year follow-up of the Tromsø Study

et al. 2007

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Aims/hypothesis Proinsulin is increased in persons at cardiovascular risk. Increased secretion of proinsulin relative to insulin has been suggested as a sign of defective conversion of proinsulin to insulin and C-peptide and is associated with beta cell dysfunction. It has also been suggested that proinsulin has more of a pro-atherogenic effect than insulin, the levels of which are also increased in the insulin resistance state. In this prospective populationbased study, we examined whether the proinsulin:insulin ratio (PIR) or insulin:glucose ratio (IGR, an insulin resistance surrogate) predicted carotid plaque size in nondiabetic participants. Materials and methods The study included 1,859 men and 1,998 women aged 25-82 years from the Tromsø Study, who were examined with B-mode high resolution ultrasound at baseline in 1994-1995 and at follow-up in [2001][2002]. All images were computer processed to yield mm 2 measures of plaque. Proinsulin and insulin were measured at baseline. All analyses were stratified for sex. Results After adjusting for age, baseline plaque area, BMI, cholesterol, HDL-cholesterol, HbA 1c , IGR, albumin:creatinine ratio, fibrinogen, BP and lifestyle factors (tobacco smoking, alcohol consumption, physical activity), PIR was significantly associated with plaque size at follow-up in women but not men. For each SD in the PIR in women, the mean plaque area increased by 0.97 mm 2 (95% CI 0.44-1.50). IGR was not associated with carotid plaque size. Conclusions/interpretation The PIR is associated with progressive carotid artery plaque size in women.

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“…5,6 Concerning carotid structure, intima-media thickness (IMT), lumen diameter and focal atherosclerosis (plaques) can be visualized and assessed by high-resolution B-mode ultrasound, a noninvasive, valid and reproducible method. 7 Several previous studies have shown positive associations between BMI and IMT. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Relationships between FM and FFM with IMT were assessed in only one recent study with inconclusive results.…”

Section: Introductionmentioning

confidence: 95%

Body composition and fat repartition in relation to structure and function of large arteries in middle-aged adults (the SU.VI.MAX study)

et al. 2005

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OBJECTIVE:To investigate associations of body composition assessed by bioimpedance analysis and anthropometric indicators of fat repartition with carotid structure and function. DESIGN: Cross-sectional epidemiological study. SUBJECTS: A total of 1014 middle-aged apparently healthy adults participating in the SU.VI.MAX study. MEASUREMENTS: Body composition (fat mass, fat-free mass) was assessed by bioimpedance analysis and anthropometric indicators of fat repartition (waist circumference (WC); waist-hip-ratio (WHR)) were simultaneously collected. Carotid ultrasound examination included measurements of intima-media thickness (IMT) at the common carotid arteries (CCA) and assessment of atherosclerotic plaques in extracranial carotid arteries. Carotid-femoral pulse-wave velocity (PWV) was used as a marker of aortic stiffness. RESULTS: In multivariate analyses adjusted for major known cardiovascular risk factors in addition to age, gender and height, fat-free mass, fat mass (FM), and WC were positively associated with CCA-IMT and lumen diameter. No significant association was found with occurrence of carotid plaques. PWV was only associated with WC. Associations of CCA-IMT and PWV with WC were not significant anymore after further adjustment on body mass index (BMI) or FM. CONCLUSION: WC was the only measurement positively associated with both early atherosclerosis markers such as CCA-IMT and arterial stiffness. Although this association depends on overall adiposity, as assessed by the BMI, it emphasizes the importance of WC in clinical practice and prevention programs as a screening tool for individuals at risk for cardiovascular disease.

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Reproducibility of Ultrasound Assessment of Carotid Plaque Occurrence, Thickness, and Morphology

Abstract: Population screening using B-mode ultrasound provides a valuable means for the detection and morphological evaluation of carotid plaques, whereas measurements of plaque thickness are subject to considerable measurement error.

Cited by 156 publications

References 33 publications

Glycated Hemoglobin Level Is Strongly Related to the Prevalence of Carotid Artery Plaques With High Echogenicity in Nondiabetic Individuals

Glycated Hemoglobin Level Is Strongly Related to the Prevalence of Carotid Artery Plaques With High Echogenicity in Nondiabetic Individuals

Proinsulin:insulin and insulin:glucose ratios as predictors of carotid plaque growth: a population-based 7 year follow-up of the Tromsø Study

Body composition and fat repartition in relation to structure and function of large arteries in middle-aged adults (the SU.VI.MAX study)

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