Grosor íntima-media carotídeo en diferentes sitios: Relación con la enfermedad coronaria en pacientes con valvulopatías

Introduction: The atherosclerosis is a generalized disease of the arterial wall. The carotid intima-media thickness (CIMT) has shown an association with cardiovascular risk factors and the prevalence of cardiovascular disease. The carotid ultrasound protocols differ considerably from one another. Objective: To compare the value of the CIMT measured in several anatomical locations for the diagnosis of significant coronary disease. Method: A total of 62 patients scheduled for valve replacement surgery with previous conventional coronary angiography (invasive) were studied. Before the surgery, the measurement of the CIMT was made in the common carotid artery (CCA), the bulb and in the internal carotid artery (ICA) through ultrasonography. The association among each of these variables, as well as the sensitivity, specificity and positive and negative predictive values were determined. Results: Only 9 of the 62 patients studied had significant coronary lesions. It was observed that for values of similar sensitivity and specificity in the carotid segments studied, a higher cut-off value of CIMT was required in the bulb (0.87 mm) and even more in the ICA (0.98 mm), in relation to the CCA (0.71 mm), thus, the latter represents the method with the highest diagnostic value in the patients studied. Conclusions: The group of patients with significant coronary lesions showed values of CIMT in each of the explored locations greater than the group without coronary lesions. The CCA was the place where the best visualization of the CIMT was obtained, and where acceptable validity parameters were achieved, as well as a good correlation with the coronary atherosclerosis of these patients .