BACKGROUND: Common carotid artery intima-media thickness (IMT), a measure of atherosclerosis, varies between peak systole and end-diastole. This difference might affect cardiovascular risk assessment. METHODS: IMT measurements of the right and left common carotid arteries were synchronized with an electrocardiogram, using the R wave for end-diastole and the T wave for peak systole. IMT was measured in 2,930 members of the Framingham Offspring Study. Multivariate regression models were generated with end-diastolic IMT, peak systolic IMT, and change in IMT as dependent variables and Framingham risk factors as independent variables. End-diastolic IMT estimates were compared with the upper quartile of IMT on the basis of normative data obtained at peak systole. RESULTS: The average age of the study population was 57.9 years. The average difference in IMT during the cardiac cycle was 0.037 mm (95% confidence interval, 0.035-0.038 mm). End-diastolic IMT and peak systolic IMT had similar associations with Framingham risk factors (total R(2) = 0.292 vs 0.275) and were significantly associated with all risk factors. In a fully adjusted multivariate model, thinner IMT at peak systole was associated with pulse pressure (P < .0001), low-density lipoprotein cholesterol (P = .0064), age (P = .046), and no other risk factors. Performing end-diastolic IMT measurements while using upper quartile peak systolic IMT normative data led to inappropriately increasing by 42.1% the number of individuals in the fourth IMT quartile (high cardiovascular risk category). CONCLUSION: The difference in IMT between peak systole and end diastole is associated with pulse pressure, low-density lipoprotein cholesterol, and age. In this study, the mean IMT difference during the cardiac cycle led to an overestimation by 42.1% of individuals at high risk for cardiovascular disease.
BACKGROUND: Common carotid artery intima-media thickness (IMT), a measure of atherosclerosis, varies between peak systole and end-diastole. This difference might affect cardiovascular risk assessment. METHODS: IMT measurements of the right and left common carotid arteries were synchronized with an electrocardiogram, using the R wave for end-diastole and the T wave for peak systole. IMT was measured in 2,930 members of the Framingham Offspring Study. Multivariate regression models were generated with end-diastolic IMT, peak systolic IMT, and change in IMT as dependent variables and Framingham risk factors as independent variables. End-diastolic IMT estimates were compared with the upper quartile of IMT on the basis of normative data obtained at peak systole. RESULTS: The average age of the study population was 57.9 years. The average difference in IMT during the cardiac cycle was 0.037 mm (95% confidence interval, 0.035-0.038 mm). End-diastolic IMT and peak systolic IMT had similar associations with Framingham risk factors (total R(2) = 0.292 vs 0.275) and were significantly associated with all risk factors. In a fully adjusted multivariate model, thinner IMT at peak systole was associated with pulse pressure (P < .0001), low-density lipoprotein cholesterol (P = .0064), age (P = .046), and no other risk factors. Performing end-diastolic IMT measurements while using upper quartile peak systolic IMT normative data led to inappropriately increasing by 42.1% the number of individuals in the fourth IMT quartile (high cardiovascular risk category). CONCLUSION: The difference in IMT between peak systole and end diastole is associated with pulse pressure, low-density lipoprotein cholesterol, and age. In this study, the mean IMT difference during the cardiac cycle led to an overestimation by 42.1% of individuals at high risk for cardiovascular disease.
Authors: D Baldassarre; F Veglia; C Gobbi; G Gallus; A Ventura; G Crepaldi; M Fisicaro; S Rimondi; G Ricci; M Mancini; M G Bong; S Collatina; C R Sirtori Journal: Atherosclerosis Date: 2000-08 Impact factor: 5.162
Authors: N Denarié; J Gariepy; G Chironi; M Massonneau; F Laskri; J Salomon; J Levenson; A Simon Journal: Atherosclerosis Date: 2000-02 Impact factor: 5.162
Authors: P Boutouyrie; D P Germain; A I Tropeano; B Laloux; F Carenzi; M Zidi; X Jeunemaitre; S Laurent Journal: Hypertension Date: 2001-11 Impact factor: 10.190
Authors: Allen J Taylor; Steven M Kent; Patrick J Flaherty; Louis C Coyle; Thor T Markwood; Marina N Vernalis Journal: Circulation Date: 2002-10-15 Impact factor: 29.690
Authors: Matthias Sitzer; Damir Puac; Alexandra Buehler; Donata A Steckel; Stephan von Kegler; Hugh S Markus; Helmuth Steinmetz Journal: Stroke Date: 2003-03-13 Impact factor: 7.914
Authors: Elaine M Urbina; Sathanur R Srinivasan; Rong Tang; M Gene Bond; Lyn Kieltyka; Gerald S Berenson Journal: Am J Cardiol Date: 2002-11-01 Impact factor: 2.778