Application of Intima-media Thickness and Early Atherosclerosis at Carotid Arteries as a Window for Cardiovascular Diseases in Preventive Cardiology

Early detection and management of preclinical atherosclerotic disease is the mainstream strategy in the prevention and treatment of atherosclerotic vascular disease. Increased intima-media thickness (IMT) and presence of atherosclerotic plaque of extracranial carotid artery (ECCA) have been identified as important markers for prediction of cardiovascular morbidity and mortality. The use of carotid ultrasound in noninvasive cardiology also gains much attention because of the advantage of high reproducibility in the measurements of IMT and ECCA atherosclerotic plaque scores. The superior role of carotid IMT as a good index of preclinical atherosclerosis in association with cardiovascular risk factors leads to worldwide application, not only in epidemiologic observations but also in pharmacologic intervention studies. Regarding the measurements of IMT, common carotid artery has been demonstrated to be highly reliable and easily accessible as compared with those measured at other segments in carotid arteries. Considering the nature of noninvasive, repeatability and reliability, we have demonstrated the feasibility of the measurements of carotid atherosclerosis in community-based, occupational and clinical studies in Taiwan. Thus, this review focuses on the rational and practical use of carotid ultrasound as a window for cardiovascular disease.