Comparison of B‐Mode Ultrasound, 3‐Dimensional Ultrasound,and Magnetic Resonance Imaging Measurements of Carotid Atherosclerosis

Objective. We compared the intraobserver and interscan variability of carotid atherosclerosis measured using B‐mode ultrasound for quantifying intima media thickness (IMT), 3‐dimensional ultrasound (3DUS) for quantifying vessel wall volume (VWV) and total plaque volume (TPV), and magnetic resonance imaging (MRI) for measuring VWV. We also evaluated the associations of these measurements and sample sizes required to detect specific changes in patients with moderate atherosclerosis. Methods. Ten patients were evaluated with B‐mode ultrasound, MRI, and 3DUS twice within 14 ± 2 days. Measurements of IMT, MRI VWV, 3DUS VWV, and 3DUS TPV were performed by single observers using manual (VWV and TPV) and semiautomated (IMT) segmentation. Results. Intraobserver coefficients of variation were 3.4% (IMT), 4.7% (3DUS VWV), 6.5% (MRI VWV), and 23.9% (3DUS TPV). Interscan coefficients of variation were 8.1% (MRI VWV), 8.9% (IMT), 13.5% (3DUS VWV), and 46.6% (3DUS TPV). Scan‐rescan linear regressions were significant for 3DUS TPV (R² = 0.57), 3DUS VWV (R² = 0.59), and IMT (R² = 0.75) and significantly different (P < .05) for MRI VWV (R² = 0.87). Conclusions. B‐mode ultrasound‐derived IMT provided the highest intraobserver and interscan reproducibility. Three‐dimensional measurements of VWV derived from 3DUS and MRI provided both high sensitivity and high intraobserver and interscan reliability.     

Mapping spatial and temporal changes in carotid atherosclerosis from three-dimensional ultrasound images

This study was designed to evaluate changes in carotid atherosclerosis using plaque and wall thickness maps derived from three-dimensional ultrasound (3DUS) images. Five subjects with carotid stenosis were scanned at baseline and 3 mo as part of a placebo-controlled intensive statin treatment study and three subjects with moderate atherosclerosis were scanned at baseline and again within 14 +/- 2 d. 3DUS-derived vessel wall volume (VWV) was measured using manual segmentation to provide segmentation contours that were used to generate scan and rescan carotid atherosclerosis thickness maps and thickness difference maps. There was no significant difference in VWV between scan and rescan for the three subjects scanned twice in 2 wk or the single subject treated with placebo. There was a significant difference between scan and rescan VWV for carotid stenosis subjects treated with atorvastatin (p < 0.001). Carotid atherosclerosis thickness difference maps showed visual qualitative evidence of thickness changes in vessel wall and plaque thickness in the common carotid artery for all statin-treated subjects and no change in a placebo-treated subject and subjects scanned twice in 2 wk. Carotid atherosclerosis thickness difference maps generated from 3DUS images provide evidence of vessel wall and plaque thickness changes for all subjects assessed.     

Validation of 3D ultrasound vessel wall volume: an imaging phenotype of carotid atherosclerosis

Carotid atherosclerotic lesions are a major cause of stroke and the identification and quantification of such lesions in patients is important for the development of a better understanding of atherogenesis in high risk populations and for the design of studies to assess treatment efficacy. Our objective was to develop and validate a new three-dimensional ultrasound (3DUS) measurement or phenotype of carotid atherosclerosis, vessel wall volume (VWV), which is a three-dimensional measurement of vessel wall thickness and plaque within the carotid arteries measured in 3DUS images. To assess both intraobserver and interscan variability, 3DUS images were acquired from the right and left carotid arteries of ten subjects with carotid atherosclerosis scanned twice within a period of 2 wk. For both VWV and total plaque volume (TPV), an expert observer performed five measurement trials of all images acquired at baseline scan and 2-wk rescan with a 5-d period between measurement trials for images. Images were re-randomized for each measurement trial and both TPV and VWV were measured by observers who were blinded to subject identification for each time-point measurement. Coefficients of variation (COV) and intraclass correlation coefficients (ICC), for VWV measurements indicated higher intraobserver (scan COV = 4.6% ICC = 0.95, rescan COV = 3.4%, ICC = 0.96) and interscan reproducibility (COV = 5.7%, ICC = 0.85) than TPV measurements (intraobserver variability scan COV = 22.7% ICC = 0.85, rescan COV = 21.1% ICC = 0.88 and interscan variability, COV = 31.1%, ICC = 0.83), although absolute variances for both phenotypes were very similar (VWV = 90 mm3, TPV = 80 mm3).     

Three-dimensional Ultrasound Quantification of Intensive Statin Treatment of Carotid Atherosclerosis

This study was designed to evaluate 3-D ultrasound (3DUS)–derived vessel wall volume (VWV), a 3-D measurement of the carotid artery intima and media, including atherosclerotic plaque, in patients enrolled in a randomized placebo-controlled three-month study of intensive atorvastatin treatment. Thirty-five subjects with carotid stenosis >60% who provided written informed consent and completed a randomized, double-blind, placebo-controlled study were evaluated at baseline and at three months after receiving either 80 mg atorvastatin (16 subjects, nine male, mean age 68 ± 8.6 y) or placebo (19 subjects, 15 male, mean age 70 ± 9.4 y) daily. 3DUS images were acquired and 3DUS VWV was manually segmented by a single observer. Individual lumen and wall segmentation contours were also used to generate carotid atherosclerosis thickness difference maps by establishing correspondence between points along the vessel wall and lumen segmentation contour surfaces, and digitally subtracting registered baseline and follow-up thickness maps. 3DUS VWV increased by 70 ± 140 mm³ (+4.9 ± 10.3%) in the placebo group and decreased by 30 ± 110 mm³ (-1.4 ± 7.7%) in the atorvastatin group (p < 0.05). Two-dimensional maps generated from the VWV measurements show localized heterogeneity and vessel wall thickness changes for all subjects, mainly in the common carotid artery. Carotid 3DUS VWV is a quantitative measure of atherosclerosis burden including the intima, media and plaque, with sensitivity to detect changes over short periods of time. Quantitative VWV thickness difference maps provide visual evidence of the spatial and temporal dynamics of carotid artery changes. (E-mail: gep@imaging.robarts.ca)     

Association between serum testosterone concentration and carotid atherosclerosis in men with type 2 diabetes

OBJECTIVE: There is evidence to suggest that low concentrations of testosterone are associated with an increased risk of cardiovascular disease in men. The aim of this study was to evaluate the relationship between serum testosterone concentration and carotid atherosclerosis as well as major cardiovascular risk factors in men with type 2 diabetes. RESEARCH DESIGN AND METHODS: Serum free and total testosterone concentrations were measured in 253 consecutive men with type 2 diabetes. The relationships between serum testosterone concentration and carotid atherosclerosis, determined by ultrasonographically evaluated intima-media thickness (IMT) and plaque score (PS) in a subgroup of 154 diabetic patients, as well as major cardiovascular risk factors, including age, blood pressure, and lipid concentrations, were evaluated. RESULTS: Inverse correlations were found between free testosterone (F-tes) concentration and IMT (r = -0.206, P = 0.0103) and between F-tes concentration and PS (r = -0.334, P < 0.001). The IMT and PS were significantly greater in patients with lower concentrations of F-tes (<10 pg/ml) than in patients with higher concentrations of F-tes (1.01 +/- 0.29 vs. 0.91 +/- 0.26 mm, P = 0.038; 4.5 +/- 3.8 vs. 2.4 +/- 3.2, P = 0.0003; respectively). An inverse correlation was found between serum F-tes concentration and age (r = -0.420, P < 0.0001). A positive correlation was found between serum F-tes and total cholesterol concentrations (r = 0.145, P = 0.0238). CONCLUSIONS: Serum F-tes concentration is inversely associated with carotid atherosclerosis determined by ultrasonographically evaluated IMT and PS in men with type 2 diabetes.     

Reduced IGFBP-1 is associated with thickening of the carotid wall in type 2 diabetes

OBJECTIVE: The aim of the present study was to assess the role of the insulin-like growth factor (IGF) system and lipids in predicting the carotid intima-media thickness (IMT) in type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 239 type 2 diabetic participants in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study (76 women) aged 50-75 years were examined before fenofibrate intervention. Patients underwent carotid ultrasonography for determination of IMT. IGF-I, IGF binding protein 1 (IGFBP-1), IGFBP-3, cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, apolipoprotein B (apoB), lipoprotein(a) (Lp(a)), glucose, HbA(1c), and C-peptide were measured in fasting samples. Patients were divided in groups without (n = 168) and with (n = 71) clinical cardiovascular disease (CVD). RESULTS: Partial correlations adjusted for age, sex, BMI, and diabetes duration showed an inverse association of IGFBP-1 with C-peptide (r = -0. 24, P = 0.018) and with maximal IMT (r = -0.42, P < 0.001), whereas IGF I and IGFBP-3 correlated positively with several risk-promoting lipid parameters. In linear regression analysis controlling for age, sex, BMI, diabetes duration, and presence or absence of oral antihyperglycemic or insulin medication, determinants of IMT were age, IGFBP-1, pulse pressure, Lp(a), diabetes duration, and insulin treatment. IGFBP-1 persisted in the model for subjects with CVD. CONCLUSIONS: In summary, a decrease in IGFBP-1 is a marker of carotid IMT thickening in patients with type 2 diabetes.     

脂蛋白(a)、同型半胱氨酸、超敏C反应蛋白和颈动脉内膜中层厚度与高血压合并冠心病相关性研究

目的 研究脂蛋白(a)[LP(a)]、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)和颈动脉内膜中层厚度(IMT)与高血压合并冠心病患者的相关性.方法 收集符合入选标准的原发性高血压病患者145例,根据是否合并冠心病分为原发性高血压病组(对照组)70例和原发性高血压合并冠心病组(观察组)75例.分析LP(a)、...     

Relationship between carotid artery atherosclerosis and bulb geometry

The carotid bifurcation is a common site of atherosclerotic plaque. Plaque development is thought to occur preferentially at geometrically predisposed areas such as arterial branch points. The aim of this study was to investigate the geometric and anatomical variables that contribute to the development of carotid plaque using three-dimensional (3D) ultrasound. Sixty-seven consecutive outpatients referred for elective coronary angiography underwent 3D carotid ultrasound scans for the purpose of carotid plaque quantification. Geometric quantification of the left and right carotid bulbs were performed retrospectively on this study population. Geometric values such as angle, area and length of the carotid bulb and the bifurcation were determined using QLAB software (Philips Healthcare). Plaque volume within the carotid bulb and artery branches was quantified using the stacked contour method. Pearson’s correlation and linear regression analysis were used to determine the relationship between anatomical variables and plaque volume. The mean age for the total patient population was 65.9?±?11.5 years. Carotid bulb inflow area (BIA) (r?=?0.28, p?=?0.001), bulb volume (BV) (r?=?0.21, p?=?0.01) and bifurcation angle (BifA) (r?=?0.18, p?=?0.04) showed a positive linear relationship with plaque volume. In contrast, internal carotid artery angle (ICAA) (r?=???0.18, p?=?0.04) and bulb flare (r?=???0.20, p?=?0.02) displayed a negative linear relationship with plaque volume. When adjusting for age and sex, only the BIA remained significant (β?=?0.18, p?=?0.04). Geometric variables were identified as potential risk factors associated with plaque volume in the carotid bulb. Further analysis of the evolution of the BIA as well as the relationship to other geometric variables could create a stronger predictive model of atherosclerosis as well as assist in preoperative planning.     

Serum parathyroid hormone is associated with carotid intima-media thickness in postmenopausal women

Objectives: To test whether parathyroid hormone (PTH) might be related to the development of atherosclerosis in postmenopausal women, we measured serum levels of PTH, the carotid intima‐media thickness (IMT), and other clinical and biochemical parameters. Methods: One hundred and seven postmenopausal women were recruited for this study. The serum level of PTH was measured by immunoradiometric assay, and carotid IMT was measured with high resolution B‐mode ultrasonography. Results: On the basis of bivariate correlation analyses or unpaired t‐tests, the body mass index (BMI), waist circumference, estimated glomerular filtration rate, and 25‐hydroxyvitamin D were not associated with carotid IMT. In contrast, age (r = 0.414, p < 0.001), serum level of PTH (r = 0.304, p = 0.001), hypertension (p < 0.001), and hypercholesterolaemia (p = 0.004) were related to carotid IMT. On the basis of multiple regression analysis, the serum level of PTH (β = 0.198, p = 0.029), as well as age (β = 0.309, p = 0.001) and hypertension (β = 0.262, p = 0.006), were independent predictors of carotid IMT. Conclusions: Our results have demonstrated that serum PTH is an independent determinant of carotid IMT in postmenopausal women. This result suggests that serum PTH, even in the reference range, might be associated with the development of atherosclerosis or cardiovascular diseases in postmenopausal women. Further study is necessary in males and premenopausal women to fully elucidate the clinical significance of this finding.     

Detection of structural changes of large arteries by characteristics of peripheral pulse wave: comparison with high resolution ultrasonic investigation

AIM: To compare high-resolution ultrasound of major arteries and the method of vascular stiffness evaluation by digital volume pulse photoplethysmography after sublingual nitroglycerin in diagnosis of structural vascular changes. MATERIAL AND METHODS: The comparison of the two methods was made in 110 volunteers (mean age 31.9 +/- 11.5 years). The study protocol included measurement of blood pressure (BP), blood lipids and glucose, evaluation of IMT of the carotid arteries by ultrasonography, baseline stiffness index (SIbl) and after sublingual nitroglycerin (SIng) by photoplethysmography. Reproducibility of photoplethysmography was evaluated in 20 volunteers (mean age 20.3 +/- 1.4 years) with repeated measurement after 1 week. The results were tested in 40 volunteers of different age groups. RESULTS: There were significant correlations of IMT, SIbl and SIng with risk factors and close interrelations of these parameters. SIng better explained variability of IMT compared to SIbl (r = 0.79, R2 = 0.62, p < 0.001 versus r = 0.67, R2 = 0.45, p < 0.001, respectively). Relations of IMT with risk factors were lost after correction for SIng. Reproducibility of SIng was higher than SIbl (+/- 5.1% versus +/- 10.9%, respectively) and than those for IMT found in the literature. Mean IMT values for random sample evaluated by ultrasonography and calculated by estimated equation of linear regression for SIng and IMT did not differ significantly (0.576 +/- 0.087 mm versus 0.570 +/- 0.074 mm, p = 0.44; r = 0.71, p < 0.001, mean difference 0.007 +/- 0.051 mm). CONCLUSION: The method of vascular stiffness measurement is comparable with ultrasonography in terms of vessel structure evaluation and possesses higher reproducibility. The test with nitroglycerin substantially increases its diagnostic potential and reproducibility.     

Comparison of biochemical, functional and structural aspects of arterial wall properties in elderly men

OBJECTIVE: A variety of methods are available to assess arterial wall properties. The aim of this study was to investigate the relationship between some of the biochemical, functional and structural measurements of arterial wall characteristics. MATERIAL AND METHODS: The study comprised 563 elderly men at high risk of coronary heart disease. Circulating levels of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, von Willebrand factor (vWF) and tissue-type plasminogen activator antigen (tPAag) were compared with pulse wave velocity (PWV) measured by finger photoplethysmography and intima-media thickness (IMT) and plaque score of the common carotid artery. RESULTS: Levels of ICAM-1 were significantly correlated with plaque score (r = 0.17, p<0.001). Levels of vWF were significantly correlated with plaque score (r = 0.11, p = 0.009) and PWV (r = 0.12, p = 0.007), and levels of tPAag were significantly correlated with PWV (r = 0.16, p<0.001). These associations, although generally weak, remained statistically significant after adjustment for relevant cardiovascular risk factors. PWV did not correlate significantly with IMT or plaque score. CONCLUSIONS: The limited intercorrelation between biochemical, functional and structural measurements of arterial wall properties observed in the present population indicate that the various methods reflect different aspects of the atherosclerotic process.     

Role of hyperlipidemia in atherosclerotic plaque formation in the internal carotid artery

PURPOSE: The role of hyperlipidemia in atherosclerotic changes of the carotid artery is controversial. The aims of this retrospective study were to assess (1) the relationship between total serum cholesterol and triglyceride and the grade of internal carotid artery stenosis and (2) whether total serum cholesterol and triglyceride levels are independent risk factors for internal carotid artery atherosclerosis. METHODS: The files of 1,934 acute ischemic stroke patients were investigated retrospectively. The atherosclerotic involvement of the internal carotid artery was assessed via duplex sonography as percent of stenosis and was graded as follows: group 1, no plaque; group 2, <30% stenosis; group 3, 30-99% stenosis; and group 4, occlusion. RESULTS: The mean age of the patients was 66.9 +/- 12.8 years. Patients without any plaque had significantly lower cholesterol levels compared with those with any degree of internal carotid artery stenosis. Univariate analysis revealed that age (p < 0.001), sex (p < 0.001), hypertension (p < 0.05), cholesterol (p < 0.01), triglycerides(p < 0.05), and smoking (p < 0.001) were significant contributors to atherosclerosis. In the ordinal logistic regression model, age (p < 0.001), sex (p < 0.001), smoking(p < 0.001), and cholesterol (p < 0.05) remained independent predictors of internal carotid artery atherosclerosis. CONCLUSIONS: Total serum cholesterol level seems to be an independent risk factor of atherosclerosis in the carotid artery.     

2型糖尿病患者趾臂指数与颈动脉及下肢动脉内中膜厚度的相关性研究

目的分析2型糖尿病(T2DM)患者趾臂指数(TBI)与外周动脉内中膜厚度(IMT)的相关性及TBI降低的危险因素。方法选择该院内分泌科住院的T2DM患者292例作为研究对象,分析其TBI与颈、股、腘动脉IMT的相关性及TBI降低的危险因素。结果 TBI降低组(TBI<0.7)与TBI正常组(TBI≥0.7)比较,年龄,DM病程,收缩压(SBP),颈、股、腘动脉IMT,DN患病人数差异均有统计学意义(P<0.05);TBI与颈、股、腘动脉IMT均呈负相关(r=-0.331、-0.288、-0.350,P<0.001);TBI降低的危险因素为年龄(OR=1.060、P<0.001、95%CI:1.027~1.095)、DM病程(OR=1.073、P=0.001、95%CI:1.027~1.121)、SBP(OR=1.021、P=0.018、95%CI:1.004~1.039)和吸烟史(OR=2.406、P=0.008、95%CI:1.251~4.626)。结论 T2DM患者TBI与颈、股、腘动脉IMT均呈负相关,年龄、糖尿病病程、SBP和吸烟史是TBI降低的危险因素。     

Carotid plaque regression following 6-month statin therapy assessed by 3T cardiovascular magnetic resonance: comparison with ultrasound intima media thickness

Background

Cardiovascular magnetic resonance (CMR) allows volumetric carotid plaque measurement that has advantage over 2-dimensional ultrasound (US) intima-media thickness (IMT) in evaluating treatment response. We tested the hypothesis that 6-month statin treatment in patients with carotid plaque will lead to plaque regression when measured by 3 Tesla CMR but not by IMT.

Methods

Twenty-six subjects (67 ± 2 years, 7 females) with known carotid plaque (> 1.1 mm) and coronary or cerebrovascular atherosclerotic disease underwent 3T CMR (T1, T2, proton density and time of flight sequences) and US at baseline and following 6 months of statin therapy (6 had initiation, 7 had increase and 13 had maintenance of statin dosing). CMR plaque volume (PV) was measured in the region 12 mm below and up to 12 mm above carotid flow divider using software. Mean posterior IMT in the same region was measured. Baseline and 6-month CMR PV and US IMT were compared. Change in lipid rich/necrotic core (LR/NC) and calcification plaque components from CMR were related to change in PV.

Results

Low-density lipoprotein cholesterol decreased (86 ± 6 to 74 ± 4 mg/dL, p = 0.046). CMR PV decreased 5.8 ± 2% (1036 ± 59 to 976 ± 65 mm³, p = 0.018). Mean IMT was unchanged (1.12 ± 0.06 vs. 1.14 ± 0.06 mm, p = NS). Patients with initiation or increase of statins had -8.8 ± 2.8% PV change (p = 0.001) while patients with maintenance of statin dosing had -2.7 ± 3% change in PV (p = NS). There was circumferential heterogeneity in CMR plaque thickness with greatest thickness in the posterior carotid artery, in the region opposite the flow divider. Similarly there was circumferential regional difference in change of plaque thickness with significant plaque regression in the anterior carotid region in region of the flow divider. Change in LR/NC (R = 0.62, p = 0.006) and calcification (R = 0.45, p = 0.03) correlated with PV change.

Conclusions

Six month statin therapy in patients with carotid plaque led to reduced plaque volume by 3T CMR, but ultrasound posterior IMT did not show any change. The heterogeneous spatial distribution of plaque and regional differences in magnitude of plaque regression may explain the difference in findings and support volumetric measurement of plaque. 3T CMR has potential advantage over ultrasound IMT to assess treatment response in individuals and may allow reduced sample size, duration and cost of clinical trials of plaque regression.     

维持性血液透析患者颈动脉硬化及相关因素分析

目的　研究慢性肾衰竭维持性血液透析患者颈动脉硬化程度及相关因素分析。方法　收集 13例慢性肾衰竭维持性血液透析患者及 13例配对对照者性别、年龄、体重、身高、BMI及病程等一般临床资料 ;抽前臂静脉血查血红蛋白 (Hb)、尿素氮 (BUN)、肌酐 (SCr)、白蛋白 (Alb)、前白蛋白 (PA)、总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL -C)、低密度脂蛋白胆固醇 (LDL -C)、C -反应蛋白 (CRP)、血浆纤维蛋白原、补体C3、载脂蛋白A1(Apo -A1)、载脂蛋白B(ApoB)及脂蛋白 (a) [Lp (a) ];彩色B型超声仪观测双侧颈总动脉、颈动脉分叉处及颈内动脉的解剖及血流动力学 ,包括斑块、最大 [(MaximumVelocity ,V(max) ]和最小血流速度 [(MinimumVelocity ,V(min) ](即收缩期和舒张期峰值血流速度 ) ,血管内皮厚度 (即内膜 -中膜厚度 ,IMT) ,阻力指数 (RI)。结果　慢性肾衰竭维持性血液透析组与对照组比较收缩压、舒张压和CRP均显著增高 (P <0 .0 1) ;Hb显著降低 (P <0 .0 5 ) ;Alb和PA显著降低 (P <0 .0 1)。原发疾病为高血压的患者CRP较原发疾病为慢性肾炎患者显著升高 (P <0 .0 1)。高血压组斑块发生率明显增高 (P <0 .0 1)。慢性肾衰竭维持性血液透析组平均IMT、最大IMT、V(min)、RI、斑块发生率与对照组相     

Carotid arterial stiffness as a surrogate for aortic stiffness: relationship between carotid artery pressure-strain elastic modulus and aortic pulse wave velocity.

Common carotid arterial (CCA) stiffness can be assessed during carotid ultrasonography, but its association with aortic stiffness, a well-defined cardiovascular risk factor, has not been clarified. This study examines the relationship between CCA and aortic stiffness. CCA pressure-strain elastic modulus (Ep) and aortic pulse wave velocity (APWV) were evaluated in 110 healthy volunteers (age 56.2 +/- 14.6 y) by B-mode and Doppler ultrasonography. CCA Ep increased linearly with age and was higher in men than in women (model r2 = 0.50, p < 0.001). APWV increased quadratically with age (model r2 = 0.54, p < 0.001), similarly for women and men. Both CCA Ep and APWV were linearly associated with systolic blood pressure (BP) (r = 0.53 and 0.46, respectively) but not with diastolic BP. A linear relationship was found between CCA Ep and APWV (APWV = 194.7 + 5.67 x Ep [model r2 = 0.42, p < 0.001]). CCA Ep was associated with APWV (p < 0.001) independent of age, gender, and BP (model r2 = 0.62, p < 0.001), and the most parsimonious model to explain APWV included CCA Ep and age (APWV = 601.73 - 15.64 x age + 0.223 x age2 + 2.69 x Ep [model r2 = 0.60, p < 0.001]). Thus, CCA Ep is moderately associated with APWV. CCA stiffness as assessed by B-mode may be useful as a surrogate for aortic stiffness.     

Xanthelasma is not associated with increased risk of carotid atherosclerosis in normolipidaemia

OBJECTIVES: Extracranial carotid artery (ECCA) atherosclerosis is well known to be associated with cardiovascular diseases. This study aims to investigate the difference of ECCA atherosclerosis between patients with xanthelasma and control subjects in normolipidaemia. METHODS: Carotid atherosclerosis (CA) of 41 (8 males and 33 females) patients with xanthelasma and normolipidaemia, defined as levels of cholesterol below 6.21 mmol/l and triglyceride below 2.26 mmol/l, recruited from Department of Dermatology was compared with that of 85 age- and gender-matched control subjects. The extent and severity of CA were measured by high-resolution B-mode ultrasound and expressed as the mean intima-media thickness (IMT) of the common carotid artery (CCA) and ECCA plaque score. Mixed-effects model and multivariate logistic regression analyses were used to estimate the association between xanthelasma and CA. RESULTS: Patients with xanthelasma showed significantly higher levels of low-density lipoprotein cholesterol (LDL-C) levels and higher body mass index (BMI) compared with the control group. Mixed models identified age, male gender, smoking and subjects of hypertension with medication, but not the presence of xanthelasma, were associated with an increase of CCA IMT. Multivariate logistic regression analysis revealed subjects of male gender, and hypertension with medication, but not the presence of xanthelasma, associated with thicker IMT, defined as IMT >or= 75th percentile, or ECCA plaque score >or= 3. CONCLUSIONS: Normolipidaemia with xanthelasma is not significantly associated with CA, but did relate with adverse cardiovascular profiles, such as higher BMI, waist circumference and LDL-C levels.     

年轻人颈动脉内中膜厚度与血压及QT离散度的相关性研究

目的 探讨18～35岁年轻人颈动脉内中膜厚度(intima-media thickness,IMT)与血压及QT离散度的关系.方法 对107例18～35岁年轻人测量血压、体质量指数(body mass index,BMI),根据BMI将研究对象分为正常体质量组、肥胖组,应用超声对两组年轻人颈动脉进行检测,分析两组间颈动脉IMT与血压及QT离散度的关系.结果 与正常体质量组比较,肥胖组血压、IMT、QT离散度增大,差异有统计学意义(P<0.05);IMT与收缩压呈直线正相关[左侧颈动脉IMT(LIMT):r=0.224,P=0.021;右侧颈动脉IMT(RIMT):r=0.193,P=0.047),与舒张压无明显相关(LIMT:r=0.123,P=0.210;RIMT:r=0.138,P=0.159);QT离散度>50 ms者发生IMT异常的危险度高于QT离散度≤50ms者(OR=6.223,P<0.05).结论 18～35岁年轻人IMT与收缩压呈正相关,QT离散度增大是IMT异常的高危因素,QT离散度>50 ms、收缩压>120 mm Hg(1 mm Hg=0.133 kPa)应行IMT检查.     

阻塞性呼吸暂停综合征与颈动脉内膜中层厚度相关分析

目的:探讨阻塞性呼吸暂停综合征(OSAHS)与颈动脉内膜中层厚度(IMT)之间的关系。方法:对应用多导睡眠监测仪监测诊断的96例OSAHS患者进行彩色多普勒超声颈动脉IMT检测,并将OSAHS患者分成轻度组(32例)、中度组(34例)、重度组(30例),分析颈动脉IMT与睡眠呼吸紊乱指数(AHI)、平均血氧饱和度(SaO2)、夜间最低SaO2、SaO2<90%时间及氧减指数的相关性。结果:轻、中、重度3组间颈动脉IMT的差异有统计学意义(P<0.05),且随着OSAHS程度加重颈动脉IMT有增加趋势。AHI(r=0.509,P<0.001)、SaO2<90%时间(r=0.351,P<0.01)、氧减指数(r=0.472,P<0.001)与颈动脉IMT呈正相关,夜间最低SaO2(r=-0.391,P<0.01)与IMT呈负相关。结论:OSAHS与颈动脉IMT相关,随着阻塞性呼吸不足持续时间的延长和SaO2的下降,颈动脉IMT增厚的可能性增加。