Serum Lipids and Lipoproteins and Carotid Artery Wall Intimamedia Thickness in a Population of Menopausal Women
Salvatore Santo SignorelliSciacchitano SalvatoreDiPino LuigiCosta Maria PiaGiuseppe PennisiS Caschetto
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Objective: To assess the influence of aging on serum lipids and lipoproteins in menopausal women and to determine whether arterial hypertension can determine carotid artery wall intima-media thickening in these subjects. Design: We assessed cholesterol, low density lipoprotein cholesterol, triglycerides, and carotid artery wall intima-media thickness in 729 menopausal women aged 40-65 years, divided into four age groups (40-45 years. 46-50 years. 51-55 years, and 56-60 years). Results: Serum lipids and lipoproteins rose progressively in the different age groups. Carotid wall thickness also increased and was more evident when accompanied by arterial hypertension. Conclusions: Our results suggest that elevated serum lipids and lipoproteins are interrelated with increased carotid artery wall intima-media thickness. Moreover, they showed the benefits of hormone replacement therapy. {Memopause 1999:6:230-232. © 1999. The North American Menopause Society.)Keywords:
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Intima-media thickness
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Carotid intima-media thickness (cIMT) is a surrogate marker of early atherosclerotic changes in children. cIMT-studies are hard to compare, due to variations in ultrasound protocols, especially regarding the common carotid artery (CCA) segment measured in relation to the bulb. This study's purpose was therefore to compare two distinct CCA segments in children, to see if cIMT values differ substantially according to the site of measurement. cIMT was assessed after power calculation in 30 children (15 girls) aged 8–17, using B-Mode ultrasound (5–13 MHz) at two CCA locations. The first measurement was performed over a distance of 1 cm immediately after the bulb (A), the second 1cm proximal the bulb (B) over the same distance of 1cm length. Means of end-diastolic far wall cIMT were compared between measurement A and B. cIMT in 30 participants was 0.51±0.06 mm for measurement A and 0.51±0.05 mm for measurement B. Results did not differ significantly (p = .947) over a distance of 2 cm after the bulb. According to our results, studies measuring CCA IMT within the first 2 cm, either close to the bulb or further proximal, can be compared. This will improve interpretation of data and application of reference values.
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Rotterdam Study
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The intima-media thickness (IMT) of common carotid artery (CCA) can serve as an important indicator for the assessment of cardiovascular diseases (CVDs). In this paper an improved approach for automatic IMT measurement with low complexity and high accuracy is presented. 100 ultrasound images from 100 patients were tested with the proposed approach. The ground truth (GT) of the IMT was manually measured for six times and averaged, while the automatic segmented (AS) IMT was computed by the algorithm proposed in this paper. The mean difference ± standard deviation between AS and GT IMT is 0.0231 ± 0.0348 mm, and the correlation coefficient between them is 0.9629. The computational time is 0.3223 s per image with MATLAB under Windows XP on an Intel Core 2 Duo CPU E7500 @2.93 GHz. The proposed algorithm has the potential to achieve real-time measurement under Visual Studio.
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Aim To determine whether small,dense low density lipoprotein cholesterol( sdLDLC) affects common carotid artery intima-media thickness( CCA-IMT) or not. Methods 130 patients who had dyslipidemia,diabetes mellitus,hypertension,or smokers participated in this experiment. SdLDLC was collected from automatic analyzer,and CCA-IMT analysis datas were obtained from high-resolution B-mode ultrasound. Results The sdLDLC in CCA-IMT thickening group was significantly higher than that in CCA-IMT normal group( 43. 97 ± 11. 35 mg / dL vs 26. 01 ± 7. 62 mg / dL,P 0. 001). The positive association of CCA-IMT with sdLDLC was significant( r = 0. 857,P 0001). Conclusions This result indicates that sdLDLC was the best marker of CCA-IMT and suggests that quantitative measurement of sdLDLC provides useful information for the risk assessment of CCA-IMT.
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The intima-media thickness (IMT) of the common carotid artery (CCA) is an established indicator of cardiovascular disease (CVD). There have been reports about the difference between the left and the right sides of the CCA IMT and its importance when evaluated with various risk factors as well as their association with the risk of stroke. In this study, we use an automated system based on snakes, for segmenting the CCA and perform measurements of the IMT of the carotid artery and provide their differences between the left and right sides. The study was performed on 205 longitudinal-section ultrasound images acquired from 87 men and 118 women at a mean±SD age of 63±10.47 years, out of which 51 had cardiovascular symptoms. A cardiovascular expert manually measured the IMT on the left CCA side (mean±standard deviation = 0.79±0.21 mm) and the right CCA side (0.76±0.33 mm). The left and right IMT automated measurements were 0.70±0.15 mm and 0.66±0.15 mm, respectively. We found no statistical significant differences: 1) between the left and right IMT measurements, for both the manual and automated measurements, and 2) between the manual and automated measurements for both sides. These findings suggest that the measurement of the CCA IMT on one side only is enough (and this is in agreement with other studies), as well as automated measurements can be used.
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To determine site specific carotid intima-media thickness: common-carotid artery and carotid bifurcation in hypercholesterolemia patients as a marker for atherosclerosis.Fifty patients with hypercholesterolemia and twenty controls were selected after getting informed consent regarding the investigation of carotid- intima media thickness by B-mode ultrasound. All the patients of hypercholesterolemia with LDL-C > 160mg/dL had family history of coronary artery diseases. This procedure was carried out in the Radiology Department of Dr. Ziauddin Hospitals. Measurement of carotid -intima media thickness, B-mode ultrasonography of common carotid artery, carotid bifurcation and internal carotid artery (left and right carotid arteries) was performed with Toshiba (M# SSA-580A/E2) ultrasound scanner with linear probe. The posterior or far wall of the carotid artery is, the distance between the leading edge first bright line (lumen -intima interface) and the leading edge of the second bright line (media-adventitia interface) of far wall was recorded as intima -media thickness. The average mean of six segments of intima-media thickness was taken as mean CIMT of right and left common carotid, bifurcation and internal carotid arteries.Maximal CIMT was significantly increased at sites common carotid, carotid bifurcation and internal carotid arteries in fifty patients with hypercholesterolemia as compared to controls. At carotid bifurcation mean of maximal CIMT was (0.9+ 0.3mm). Range of maximum CIMT in hypercholesterolemia patients was (0.8- 3.3mm) and in controls (0.4- 0.8 mm). The thickness was more frequently increased at site of bifurcation.Carotid intima- media thickness in hypercholesterolemia patients was increased and carotid bifurcation was site that has shown greater increase in intima-media thickness and plaques in these patients predict high risk for atherosclerosis.
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