Correlation between carotid intima‑media roughness and cardiovascular risk factors

Wu,Yu; Lu,Xuan; Zhang,Li; Cheng,Xinyao; Yuan,Li; Xie,Mingxing; Lv,Qing

doi:10.3892/etm.2019.7646

Correlation between carotid intima‑media roughness and cardiovascular risk factors

Authors:
- Yu Wu
- Xuan Lu
- Li Zhang
- Xinyao Cheng
- Li Yuan
- Mingxing Xie
- Qing Lv
View Affiliations

Affiliations: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China, Cardiovascular Division, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
Published online on: June 4, 2019 https://doi.org/10.3892/etm.2019.7646
Pages: 49-56
Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Arterial intima‑media roughness (IMR) may indicate an early manifestation of atherosclerosis. To date, few studies have been performed to quantitatively evaluate carotid IMR by ultrasonography (US). The aim of the present study was to analyze the effect of cardiovascular risk factors on carotid IMR. A total of 185 subjects were enrolled for US examination of carotid arteries. Carotid intima‑media thickness (IMT) and IMR were measured in US images by a novel automatic software. According to the number of combined high‑risk factors for coronary heart disease, subjects were assigned to four groups (risk groups 0, 1, 2 and 3+). IMR was lowest in risk group 0 (32.9±2.7 µm), higher in risk group 1 (64.5±6.9 µm; P<0.01 vs. risk group 0) and highest in risk groups 2 and 3+ (89.1±7.4 and 92.0±6.7 µm, respectively; P<0.01 vs. risk groups 0 and 1). According to a multivariate regression analysis, age, systolic blood pressure, smoking status and the triglyceride/high‑density lipoprotein cholesterol ratio were significant predictors of IMR. There was a progressive increase in carotid artery plaque with increasing tertiles of IMR (4.9, 33.9 and 53.2% in tertiles 1, 2 and 3, respectively; P<0.05). Compared with that of subjects in the lowest tertile of IMR, those in the highest tertile had a significantly elevated risk of the presence of plaque in the carotid tree (odds ratio=10.61, 95%CI: 2.15‑52.49, P=0.004). Quantification of carotid IMR from US images with this software is feasible, and carotid IMR, which may help estimate the extent of atherosclerosis, may be used as a complementary factor to stratify patients with cardiovascular risk factors.

View Figures

View References

1	He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, Wang J, Chen CS, Chen J, Wildman RP, et al: Major causes of death among men and women in China. N Engl J Med. 353:1124–1134. 2005. View Article : Google Scholar : PubMed/NCBI
2	Touboul PJ, Labreuche J, Bruckert E, Schargrodsky H, Prati P, Tosetto A, Hernandez-Hernandez R, Woo KS, Silva H, Vicaut E and Amarenco P: Hdl-c, triglycerides and carotid IMT: A meta-analysis of 21,000 patients with automated edge detection IMT measurement. Atherosclerosis. 232:65–71. 2014. View Article : Google Scholar : PubMed/NCBI
3	Lethen H, Tries HP, Kersting S, Bramlage P and Lambertz H: Improvement of coronary microvascular function after angiotensin receptor blocker treatment with irbesartan in patients with systemic hypertension. J Clin Hypertens (Greenwich). 13:155–161. 2011. View Article : Google Scholar : PubMed/NCBI
4	Luijendijk P, Lu H, Heynneman FB, Huijgen R, de Groot EE, Vriend JW, Vliegen HW, Groenink M, Bouma BJ and Mulder BJ: Increased carotid intima-media thickness predicts cardiovascular events in aortic coarctation. Int J Cardiol. 176:776–781. 2014. View Article : Google Scholar : PubMed/NCBI
5	Schmidt-Trucksass A, Sandrock M, Cheng DC, Müller HM, Baumstark MW, Rauramaa R, Berg A and Huonker M: Quantitative measurement of carotid intima-media roughness-effect of age and manifest coronary artery disease. Atherosclerosis. 166:57–65. 2003. View Article : Google Scholar : PubMed/NCBI
6	Dalla Pozza R, Pirzer R, Beyerlein A, Weberruß H, Oberhoffer R, Schmidt-Trucksäss A, Netz H and Haas N: Beyond intima-media-thickness: Analysis of the carotid intima-media-roughness in a paediatric population. Atherosclerosis. 251:164–169. 2016. View Article : Google Scholar : PubMed/NCBI
7	Homma S, Hirose N, Ishida H, Ishii T and Araki G: Carotid plaque and intima-media thickness assessed by b-mode ultrasonography in subjects ranging from young adults to centenarians. Stroke. 32:830–835. 2001. View Article : Google Scholar : PubMed/NCBI
8	Lind L: Circulating markers of inflammation and atherosclerosis. Atherosclerosis. 169:203–214. 2003. View Article : Google Scholar : PubMed/NCBI
9	Willerson JT: Systemic and local inflammation in patients with unstable atherosclerotic plaques. Prog Cardiovasc Dis. 44:469–478. 2002. View Article : Google Scholar : PubMed/NCBI
10	Toutouzas K, Grassos H, Synetos A, Drakopoulou M, Tsiamis E, Moldovan C, Agrogiannis G, Patsouris E, Siores E and Stefanadis C: A new non-invasive method for detection of local inflammation in atherosclerotic plaques: Experimental application of microwave radiometry. Atherosclerosis. 215:82–89. 2011. View Article : Google Scholar : PubMed/NCBI
11	Belcaro G, Nicolaides AN, Laurora G, Cesarone MR, De Sanctis M, Incandela L and Barsotti A: Ultrasound morphology classification of the arterial wall and cardiovascular events in a 6-year follow-up study. Arterioscler Thromb Vasc Biol. 16:851–856. 1996. View Article : Google Scholar : PubMed/NCBI
12	Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, et al: 2013 ESH/ESC guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the european society of hypertension (ESH) and of the european society of cardiology (ESC). J Hypertens. 31:1281–1357. 2013. View Article : Google Scholar : PubMed/NCBI
13	Gnasso A, Irace C, Mattioli PL and Pujia A: Carotid intima-media thickness and coronary heart disease risk factors. Atherosclerosis. 119:7–15. 1996. View Article : Google Scholar : PubMed/NCBI
14	American Diabetes Association: Standards of medical care in diabetes-2011. Diabetes Care. 1 (Suppl 34):S11–S61. 2011. View Article : Google Scholar
15	Zhou B; Coorperative Meta-Analysis Group Of China Obesity Task Force, : Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Zhonghua Liu Xing Bing Xue Za Zhi. 23:5–10. 2002.(In Chinese). PubMed/NCBI
16	Expert Panel on Detection and Evaluation and Treatment of High Blood Cholesterol in Adults, . Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 285:2486–2497. 2001. View Article : Google Scholar : PubMed/NCBI
17	Touboul PJ, Hennerici M, Meairs S, Adams H, Amarenco P, Bornstein N, Csiba L, Desvarieux M, Ebrahim S, Hernandez Hernandez R, et al: Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European stroke conferences, mannheim, Germany, 2004, Brussels, Belgium, 2006, and hamburg, Germany, 2011. Cerebrovasc Dis. 34:290–296. 2012. View Article : Google Scholar : PubMed/NCBI
18	Xu X, Zhou Y, Cheng X, Song E and Li G: Ultrasound intima-media segmentation using hough transform and dual snake model. Comput Med Imaging Graph. 36:248–258. 2012. View Article : Google Scholar : PubMed/NCBI
19	Wendelhag I, Gustavsson T, Suurküla M, Berglund G and Wikstrand J: Ultrasound measurement of wall thickness in the carotid artery: Fundamental principles and description of a computerized analysing system. Clin Physiol. 11:565–577. 1991. View Article : Google Scholar : PubMed/NCBI
20	Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O and Schaefer F: Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation. 106:100–105. 2002. View Article : Google Scholar : PubMed/NCBI
21	Polak JF, Pencina MJ, Pencina KM, O'Donnell CJ, Wolf PA and D'Agostino RB Sr: Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med. 365:213–221. 2011. View Article : Google Scholar : PubMed/NCBI
22	Gardin JM, Bartz TM, Polak JF, O'Leary DH and Wong ND: What do carotid intima-media thickness and plaque add to the prediction of stroke and cardiovascular disease risk in older adults? The cardiovascular health study. J Am Soc Echocardiogr. 27:998–1005. 2014. View Article : Google Scholar : PubMed/NCBI
23	Polak JF, Szklo M and O'Leary DH: Associations of coronary heart disease with common carotid artery near and far wall intima-media thickness: The Multi-Ethnic Study of Atherosclerosis. J Am Soc Echocardiogr. 28:1114–1121. 2015. View Article : Google Scholar : PubMed/NCBI
24	Gigante B, Leander K, Vikström M, Baldassarre D, Veglia F, Strawbridge RJ, McLeod O, Gertow K, Sennblad B, Shah S, et al: Low levels of IgM antibodies against phosphorylcholine are associated with fast carotid intima media thickness progression and cardiovascular risk in men. Atherosclerosis. 236:394–399. 2014. View Article : Google Scholar : PubMed/NCBI
25	Wu Y, Xie M, Zhang L, Lu X, Cheng X and Lv Q: Carotid intima-media roughness and elasticity in hypertensive patients with normal carotid intima-media thickness. J Ultrasound Med. 2018:(Epub ahead of print).
26	Raitakari OT, Juonala M, Kähönen M, Taittonen L, Laitinen T, Mäki-Torkko N, Järvisalo MJ, Uhari M, Jokinen E, Rönnemaa T, et al: Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: The Cardiovascular Risk in Young Finns Study. JAMA. 290:2277–2283. 2003. View Article : Google Scholar : PubMed/NCBI
27	Cheng X, Zhou Y, Jin Y, Li G, Wang H and Song E: Intima-medial thickness homogeneity in the common carotid artery: Measurement method and preliminary clinical study. J Clin Ultrasound. 40:559–565. 2012. View Article : Google Scholar : PubMed/NCBI
28	Otsuka F, Kramer MC, Woudstra P, Yahagi K, Ladich E, Finn AV, de Winter RJ, Kolodgie FD, Wight TN, Davis HR, et al: Natural progression of atherosclerosis from pathologic intimal thickening to late fibroatheroma in human coronary arteries: A pathology study. Atherosclerosis. 241:772–782. 2015. View Article : Google Scholar : PubMed/NCBI
29	Bentzon JF, Otsuka F, Virmani R and Falk E: Mechanisms of plaque formation and rupture. Circ Res. 114:1852–1866. 2014. View Article : Google Scholar : PubMed/NCBI
30	Graf IM, Schreuder FH, Hameleers JM, Mess WH, Reneman RS and Hoeks AP: Wall irregularity rather than intima-media thickness is associated with nearby atherosclerosis. Ultrasound Med Biol. 35:955–961. 2009. View Article : Google Scholar : PubMed/NCBI
31	Ishizu T, Ishimitsu T, Kamiya H, Seo Y, Moriyama N, Obara K, Watanabe S and Yamaguchi I: The correlation of irregularities in carotid arterial intima-media thickness with coronary artery disease. Heart Vessels. 17:1–6. 2002. View Article : Google Scholar : PubMed/NCBI