Ultrasonic evaluation of early carotid atherosclerosis.

Abstract

We investigated the prevalence of carotid atherosclerosis, including mild early lesions, and its association with cervical bruits and various risk factors (age, male sex, hypertension, hyperlipidemia, diabetes mellitus, obesity, and cigarette smoking) in 232 consecutive Japanese patients. High-resolution real-time B-mode ultrasonography was performed to determine the extent of atherosclerosis, and it was quantified by using a scoring system. The prevalence of carotid atherosclerosis was 49%, 59%, and 41% in all 232 patients, the 100 symptomatic patients, and the 132 asymptomatic patients, respectively. Although carotid lesions were detected frequently (87%) in the 30 patients with cervical bruits, bruits were noted in only 30% of the 88 examined patients with carotid atherosclerosis. Independent risk factors for carotid atherosclerosis in these patients were found to be age, male sex, and hyperlipidemia; diabetes mellitus was a possible risk factor for carotid atherosclerosis. Our study did not show a close association between hypertension and carotid atherosclerosis, and this might be caused by the high prevalence of hypertension in our patients. Our findings suggest an increasing prevalence of carotid atherosclerosis in the Japanese, though this should be confirmed in a populationbased study. Our study demonstrates the clinical usefulness of high-resolution B-mode ultrasonography for the evaluation of early carotid atherosclerosis. (Stroke 1990;21:1567-1572)

Asymptomatic hyperglycaemia is associated with increased intimal plus medial thickness of the carotid artery

“…IMTis a clinically useful quantitative index of carotid atherosclerosis as suggested by several investigators [15][16][17][18][19][20][21][22]. The atherosclerotic processes occurring in the coronary arteries, extracranial carotid arteries, and peripheral arteries in the legs appear to be pathologically identical [42].…”

“…However, although symptomatic subjects have been examined by invasive coronary angiography [13,14], information on asymptomatic atherosclerosis in asymptomatic hyperglycaemia is scarce. Now this can be done using high resolution Bmode imaging of the carotid artery [15][16][17][18][19][20][21][22], which enables direct and non-invasive in vivo monitoring of carotid atherosclerosis even in subjects as young as 7 years old [22]. Because of its high-distance resolution, we were able to demonstrate, for the first time, a high prevalence of increased thickness of the carotid arteries in asymptomatic hyperglycaemic non-diabetic subjects.…”

Metformin or gliclazide, rather than glibenclamide, attenuate progression of carotid intima-media thickness in subjects with type 2 diabetes

“…The conventional Bmode imaging of the extracranial common carotid artery, the carotid bulb, and the internal carotid artery in the neck was performed bilaterally from three different longitudinal projections (i.e. anterior-oblique, lateral and posterior-oblique), as well as from the transverse projection, as reported previously [16,17]. The carotid IMT defined by Pignoli and co-workers was measured as the distance from the leading edge of the first echogenic line to the leading edge of the second echogenic line [18].…”

Normative values of carotid artery intima-media thickness in healthy Korean adults and estimation of macrovascular diseases relative risk using this data in type 2 diabetes patients

“…The association of carotid artery intima-media thickness (IMT) with macrovascular diseases, such as ischemic heart disease (IHD) [1,2], stroke [3,4], and peripheral arterial occlusive diseases (PAOD) [5,6], has been well established. Macrovascular diseases are a main cause of death among patients with type 2 diabetes mellitus (T2DM) [7] and the frequency is increasing.…”