No abstract available.
Carotid Intima-Media Thickness ; Diabetic Nephropathies ; Humans

No abstract available.
Carotid Intima-Media Thickness ; Diabetic Nephropathies ; Humans

BACKGROUND: Prehypertension is a precursor of clinical hypertension and tends to increase in severity over time. Structural vascular changes have not been much investigated in adults with prehypertension. METHODS: We investigated the carotid intima-media thickness (IMT) in prehypertensive adults, pharmacologically untreated, compared with normotensive and hypertensive patients. Mean and maximum carotid IMT were obtained from six far walls of the common carotid, the bifurcation, and the internal carotid artery on both sides of the neck with high-resolution B-mode ultrasonography. RESULTS: Mean IMT was largest in the carotid bifurcation, followed by the common carotid and the internal carotid artery in all groups. Hypertensives had higher mean IMT values at all locations than normotensive controls. In prehypertensive adults, the mean and maximum IMT values were significantly higher than in normotensive controls. In contrast, there was no significant difference in the mean and maximum carotid IMT between prehypertensive adults and patients with stage 1 hypertension. The prevalence of plaques was 15.7% in prehypertensive adults, compared with 4.4% in controls, 22.2% in stage 1 hypertensives, and 29.4% in stage 2 hypertensives. CONCLUSION: Prehypertensive adults had thicker mean carotid IMT than normotensive controls and exhibited similarly abnormal carotid structure as the patients with stage 1 hypertension. These results suggest we need the continuous evaluation for early clinical detection and intervention of prehypertension.
Adult* ; Carotid Arteries ; Carotid Artery, Internal ; Carotid Intima-Media Thickness* ; Humans ; Hypertension ; Neck ; Prehypertension ; Prevalence ; Ultrasonography

OBJECTIVE: To observe the clinical therapeutic effect of Tongdu Tiaoshen acupuncture combined with carotid endarterectomy (CEA) and simple CEA on carotid artery stenosis (CAS). METHODS: A total of 60 patients with CAS were randomized into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 3 cases dropped off). Both groups were treated with eversion CEA (eCEA). The conventional treatment of internal medicine and antiplatelet drugs i.e. aspirin enteric-coated tablet and clopidogrel hydrogen sulfate tablet were given in the control group for 4 weeks. On the basis of the treatment in the control group, Tongdu Tiaoshen acupuncture was applied at Baihui (GV 20), Fengfu (GV 16), Yamen (GV 15), cervical Jiaji (EX-B 2), Dazhui (GV 14), etc. in the observation group, once a day, 1-day rest was taken after 6-day treatment, 2 weeks were as one course and totally 2 courses were required. The carotid intima-media thickness (IMT) before and after treatment was detected by ultrasonic diagnostic apparatus, the TCM symptom score was compared before and after treatment and in the follow-up of 6 months after treatment, the clinical efficacy was evaluated in the two groups. The occurrence of endpoints within 1 year was recorded. RESULTS: After treatment, the carotid IMT and TCM symptom scores were decreased compared before treatment in the both groups (P<0.05), and the changes in the observation group were greater than the control group (P<0.05). In the follow-up, the TCM symptom scores were decreased compared before treatment in the both groups (P<0.05). The total effective rate was 96.4% (27/28) in the observation group, which was superior to 88.9% (24/27) in the control group (P<0.05). There were 1 case of stoke in the observation group and 2 cases of stroke in the control group within 1-year follow-up, and there was no significant difference in the number of endpoints between the two groups within 1 year (P>0.05). CONCLUSION Tongdu Tiaoshen acupuncture combined with CEA can effectively reduce the IMT in patients with CAS, improve the TCM symptom score, the efficacy is superior to simple CEA treatment.
Acupuncture Points ; Acupuncture Therapy ; Carotid Intima-Media Thickness ; Carotid Stenosis/therapy* ; Endarterectomy, Carotid ; Humans ; Treatment Outcome

BACKGROUND/AIMS: In hypertensive patients, LV ejection fraction may be normal or high, thus limiting assessment of prognosis. This has led to a growing body of research using LV midwall fractional shortening (MWS) instead. The current study aims to assess LV midwall function in hypertension patients and to study its correlation with the intima-media thickness (IMT) of the carotid artery. METHODS: Echocardiography and ultrasonography of the carotid artery were conducted to establish a group of hypertension patients without major complications (n=136) and a control group (n=48). LV MWS was determined using two cylindrical models, and the IMT was measured. RESULTS: Compared with normotensive subjects, hypertensive adults exhibited higher LV mass index and lower LV MWS. A statistically significant correlation was found between the LV MWS and the average IMT in hypertension patients (r=-0.41). There was also a significant negative correlation among the maximum IMT (r=-0.40), LV mass index (r=-0.32), age (r=-0.31), and systolic blood pressure (r=-0.22). Regarding the prevalence of plaque in the carotid artery, the stage 1 hypertension group exhibited 16.7% prevalence, and the stage 2 hypertension group 32.9% prevalence, thereby showing far higher figures than the control group's 4.2%. CONCLUSIONS: The LV MWS in hypertension patients underwent a statistically significant decrease, and the correlation between LV MWS and the IMT of the carotid artery was found to be high compared with the general blood pressure index. LV MWS can be used as an indicator to assess the prognosis of hypertension patients.
Adult ; Blood Pressure ; Carotid Arteries ; Carotid Intima-Media Thickness ; Echocardiography ; Humans ; Hypertension ; Prevalence ; Prognosis

BACKGROUND AND OBJECTIVES: We performed this study to evaluate the feasibility and accuracy of the newly developed Korean software (KS) for measurement of the carotid intima-media thickness (IMT), which was compared with the commercial software. SUBJECTS AND METHODS: The study population consisted of 60 consecutive patients (mean of 59 years old, 27 males) undergoing transthoracic echocardiography. We measured the carotid IMT using both software packages, and also measured the intima thickness (IT) and media thickness (MT), separately, using the KS package. RESULTS: Measurement of the IMT was possible in all the study subjects with both software packages, but the separate measurements of the IT and MT was possible in only 24 patients using the KS package. The mean IMT using the commercial and KS packages were 0.727+/-0.157 and 0.733+/-0.156 mm, respectively, which were found to correlate (r=0.985, p=0.000). The mean IMT, IT and MT of the 24 patients were 0.841+/-0.138, 0.340+/-0.033 and 0.505+/-0.124 mm, respectively. The carotid IMT was correlated with the IT and MT and also with the IT/IMT, MT/IMT and IT/MT ratios (r=0.562, p=0.004; r=0.934, p=0.000; r=-0.809, p=0.000; r=0.591, p=0.002; r=-0.754, p=0.000, respectively). The IT was found not to correlate with the MT (r=0.369, p=0.076). Age was found to correlate with the IMT using both the commercial and KS packages (r=0.616, p=0.000; r=0.583, p=0.000, respectively), and with the MT and IT/IMT and IT/MT ratios (r=0.504, p=0.012; r=-0.538, p=0.007; r=-0.428, p=0.037), but not with the IT (r=0.300, p=0.154). CONCLUSION: The newly developed KS was feasible and accurate in measuring the carotid IMT, which can also be used to separately measure the IT and MT.
Aging ; Atherosclerosis ; Carotid Arteries ; Carotid Intima-Media Thickness ; Echocardiography ; Humans ; Middle Aged ; Ultrasonography*

BACKGROUND: Carotid intima media thickness (CIMT) and the presence of carotid plaque have been used for risk stratification of cardiovascular disease (CVD). To date, however, the association between multi-directional functional properties of carotid artery and CVD has not been fully elucidated. We sought to explore the multi-directional mechanics of the carotid artery in relation to cardiovascular risk. METHODS: Four hundred one patients who underwent carotid ultrasound were enrolled between January 2010 and April 2013. A high risk of CVD was defined as more than 20% of 10-year risk based on the Framingham risk score. Using a speckle-tracking technique, the longitudinal and radial movements were analyzed in the B-mode images. Peak longitudinal and radial displacements, strain and strain rate were also measured. Beta stiffness and elastic modulus index were calculated from the radial measurements. RESULTS: Of the overall sample, 13% (52) of patients comprised the high-risk group. In multivariate logistic regression, CIMT and elastic modulus index were independently associated with a high-risk of CVD {odds ratio (OR): 1.810 [95% confidence interval (CI) 1.249–2.622] and OR: 1.767 (95% CI: 1.177–2.652); p = 0.002, 0.006, respectively}. The combination of CIMT and elastic modulus index correlated with a high-risk of CVD more so than CIMT alone. CONCLUSION: The elastic modulus index of the carotid artery might serve as a novel surrogate marker of high-risk CVD. Measurement of the multi-directional mechanics of the carotid artery using the speckle tracking technique has potential for providing further information over conventional B-mode ultrasound for stratification of CVD risk.
Biomarkers* ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Intima-Media Thickness ; Elastic Modulus* ; Humans ; Logistic Models ; Mechanics ; Ultrasonography*

In clinic, intima and media thickness are the main indicators for evaluating the development of atherosclerosis. At present, these indicators are measured by professional doctors manually marking the boundaries of the inner and media on B-mode images, which is complicated, time-consuming and affected by many artificial factors. A grayscale threshold method based on Gaussian Mixture Model (GMM) clustering is therefore proposed to detect the intima and media thickness in carotid arteries from B-mode images in this paper. Firstly, the B-mode images are clustered based on the GMM, and the boundary between the intima and media of the vessel wall is then detected by the gray threshold method, and finally the thickness of the two is measured. Compared with the measurement technique using the gray threshold method directly, the clustering of B-mode images of carotid artery solves the problem of gray boundary blurring of inner and middle membrane, thereby improving the stability and detection accuracy of the gray threshold method. In the clinical trials of 120 healthy carotid arteries, means of 4 manual measurements obtained by two experts are used as reference values. Experimental results show that the normalized root mean square errors (NRMSEs) of the estimated intima and media thickness after GMM clustering were 0.104 7 ± 0.076 2 and 0.097 4 ± 0.068 3, respectively. Compared with the results of the direct gray threshold estimation, means of NRMSEs are reduced by 19.6% and 22.4%, respectively, which indicates that the proposed method has higher measurement accuracy. The standard deviations are reduced by 17.0% and 21.7%, respectively, which indicates that the proposed method has better stability. In summary, this method is helpful for early diagnosis and monitoring of vascular diseases, such as atherosclerosis.
Carotid Arteries/diagnostic imaging* ; Carotid Intima-Media Thickness ; Normal Distribution ; Ultrasonography

BACKGROUND: The present study was aimed at defining the topological characteristics of the carotid intima-media thickness (IMT) in hypertensives, and to delineate whether the characteristics were different from those of non-hypertensive vascular risk factors. METHODS: B-mode carotid ultrasonography was performed in 33 participants who were devoid of stroke, ischemic heart disease, and carotid plaques. Longitudinal carotid images were obtained at 6 angular sites, 0 degree indexed adjacent to the external carotid artery (ECA) side from axial image crossing both internal carotid artery (ICA) and ECA, and then 45 degrees, 90 degrees, 180 degrees, 225 degrees, and 270 degrees. From the level of the flow divider, with an interval of 5 mm, up to 15 mm proximally, all the carotid IMT was measured. The IMT was then analyzed according to the levels and angles and compared according to either of hypertension or non-hypertension vascular risk factors. RESULTS: The carotid IMT showed asymmetric distributions in both the hypertension and non-hypertension risk groups. The IMT difference according to hypertension was observed better in the right carotid artery than the left. The right carotid IMT in the hypertension group showed significantly higher values at the most levels, and especially at 0 degree and 180 degrees of angular sites. CONCLUSIONS: It is important to understand the different topological characteristics of the carotid IMT according to the presence of hypertension, for a better reproducibility and predictability of the ultrasonic carotid IMT measurement.
Carotid Arteries ; Carotid Artery, External ; Carotid Artery, Internal ; Carotid Intima-Media Thickness* ; Hypertension ; Myocardial Ischemia ; Risk Factors ; Stroke ; Ultrasonics ; Ultrasonography

BACKGROUNDS/AIMS: It has been suggested that there is a differential response of the vasculature to systemic risk factors for atherosclerosis. We sought to evaluate the impact of hypertension on the carotid arterial wall using new methods that can measure each arterial wall layer. METHODS: The study subjects consisted of 163 patients who underwent carotid arterial scanning using high-resolution ultrasound that could measure the left carotid intima-media, intima, and media separately. The individual carotid arterial wall thickness was measured off-line by a new method using the Canny edge-detection algorithm. RESULTS: Hypertensive patients (n=79, mean age 61.8 years) had a higher prevalence of diabetes (31.6% vs 11.9%, p=0.004) and a lower level of HDL-cholesterol than did normotensive patients (41.8+/-11.0 mg/dL vs 45.7+/-10.0 mg/dL, p=0.019). Hypertensive patients had higher carotid intima-media thickness (CIMT, 0.81+/-0.21 mm vs 0.74+/-0.18 mm, p=0.003) and carotid medial thickness (CMT, 0.46+/-0.12 mm vs 0.42+/-0.09 mm, p=0.007) than did normotensive patients, whereas carotid intimal thickness (CIT) was not significantly different (0.34+/-0.04 mm vs 0.34+/-0.04 mm, p=0.196). Multivariate analysis revealed that the independent factors of CIMT were CMT (beta=0.915, p<0.001), hypertension (beta=0.076, p=0.008), age (beta=0.074, p=0.010), and sex (beta=-0.079, p=0.005). Pearson correlation coefficient between CIMT and CMT was higher (r=0.932, p<0.001 vs r=0.445, p<0.001) than that between CIMT and CIT. The correlation between CIMT and CMT was higher (r=0.940, p<0.001 vs r=0.910, p<0.001) in hypertensive patients than in normotensive patients, whereas that between CIMT and CIT was lower (r=0.344, p=0.002 vs r=0.583, p<0.001) in hypertensive patients. CONCLUSIONS: The increased CIMT is caused by increased CMT in hypertensive patients, and this finding is compatible with the medial hypertrophy seen in hypertension. The carotid medial layer should be the focus of attention in future studies looking at hypertensive patients.
Atherosclerosis ; Blood Proteins ; Carotid Arteries ; Carotid Intima-Media Thickness ; Humans ; Hypertension ; Hypertrophy ; Multivariate Analysis ; Prevalence ; Risk Factors ; Tunica Media