Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Arterial Hypertension
MENU
Shortcuts Submit an article Author Guidelines Ahead Of Print Reviewers 2023

open access

Vol 27, No 4 (2023)
Original paper
Published online: 2023-11-14
View PDF Download PDF file View HTML
Get Citation

The overall echogenicity (GSM) of carotid intima-media complex shows a positive correlation with arterial stiffness in hypertensive patients

Francesco Natale1, Simona Covino12, Riccardo Molinari12, Mirella Limatola12, Noemi Mollo12, Roberta Alfieri12, Enrica Pezzullo1, Francesco Loffredo12, Paolo Golino12, Giovanni Cimmino23
DOI: 10.5603/ah.96896
·
Arterial Hypertension 2023;27(4):232-239.
Affiliations
  1. Vanvitelli Cardiology and Intensive Care Unit, Monaldi Hospital, Naples, Italy
  2. Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
  3. Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Italy

open access

Vol 27, No 4 (2023)
ORIGINAL PAPERS
Published online: 2023-11-14

Abstract

Background: Arterial stiffness measurement still plays a role in prediction of future cardiovascular events, thus helping for quantification of patients’ cardiovascular (CV) risk level. However, significant measurement difficulties still exist, making its widespread evaluation not routinary. At present indices of arterial stiffness have not been associated with qualitative morphological characteristics of intima-media complex. The intima-media thickness (IMT) measurement is no longer recommended in the cardiovascular disease (CVD) risk assessment due to lack of a standard acquisition protocol. The intima media gray scale median (IM-GSM) is a relatively simple measurement, acquirable during a conventional carotid color-Doppler ultrasound examination. This study aims at investigating the possible relationship between arterial stiffness and echogenicity of IM-GSM of the common carotid arteries, in patients already diagnosed with arterial hypertension.

Material and methods: A total of 421 hypertensive patients were retrospectively selected from our database of hypertension outpatients ambulatory. They were divided into two groups according to IM-GSM values (cutoff value: 30) and then subsequently compared.

Results: In our study population, subjects with IM-GSM > 30 showed a statistically increased arterial stiffness and left ventricle mass index. A weak positive correlation was also found between IM-GSM, systolic blood pressure and duration of hypertension.

Conclusion: The data presented here indicated that the variation of arterial stiffness observed in hypertensive patients is associated with structural modifications in carotid arterial wall. 

Abstract

Background: Arterial stiffness measurement still plays a role in prediction of future cardiovascular events, thus helping for quantification of patients’ cardiovascular (CV) risk level. However, significant measurement difficulties still exist, making its widespread evaluation not routinary. At present indices of arterial stiffness have not been associated with qualitative morphological characteristics of intima-media complex. The intima-media thickness (IMT) measurement is no longer recommended in the cardiovascular disease (CVD) risk assessment due to lack of a standard acquisition protocol. The intima media gray scale median (IM-GSM) is a relatively simple measurement, acquirable during a conventional carotid color-Doppler ultrasound examination. This study aims at investigating the possible relationship between arterial stiffness and echogenicity of IM-GSM of the common carotid arteries, in patients already diagnosed with arterial hypertension.

Material and methods: A total of 421 hypertensive patients were retrospectively selected from our database of hypertension outpatients ambulatory. They were divided into two groups according to IM-GSM values (cutoff value: 30) and then subsequently compared.

Results: In our study population, subjects with IM-GSM > 30 showed a statistically increased arterial stiffness and left ventricle mass index. A weak positive correlation was also found between IM-GSM, systolic blood pressure and duration of hypertension.

Conclusion: The data presented here indicated that the variation of arterial stiffness observed in hypertensive patients is associated with structural modifications in carotid arterial wall. 

Full Text:

View PDF Download PDF file View HTML
Get Citation

Keywords

carotid intima-media thickness; hypertension; arterial stiffness; echogenicity of intima-media complex; GSM; PWV

About this article
Title

The overall echogenicity (GSM) of carotid intima-media complex shows a positive correlation with arterial stiffness in hypertensive patients

Journal

Arterial Hypertension

Issue

Vol 27, No 4 (2023)

Article type

Original paper

Pages

232-239

Published online

2023-11-14

Page views

572

Article views/downloads

196

DOI

10.5603/ah.96896

Bibliographic record

Arterial Hypertension 2023;27(4):232-239.

Keywords

carotid intima-media thickness
hypertension
arterial stiffness
echogenicity of intima-media complex
GSM
PWV

Authors

Francesco Natale
Simona Covino
Riccardo Molinari
Mirella Limatola
Noemi Mollo
Roberta Alfieri
Enrica Pezzullo
Francesco Loffredo
Paolo Golino
Giovanni Cimmino

References (35)
  1. Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension. J Hypertens. 2023; 41(12): 1874–2071.
    CrossRefPubMed
  2. Arnett DK, Boland LL, Evans GW, et al. Hypertension and arterial stiffness: the Atherosclerosis Risk in Communities Study. ARIC Investigators. Am J Hypertens. 2000; 13(4 Pt 1): 317–323.
    CrossRefPubMed
  3. Visseren FLJ, Mach F, Smulders YM, et al. ESC Scientific Document Group, ESC Scientific Document Group, ESC Scientific Document Group, ESC National Cardiac Societies, ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021; 42(34): 3227–3337.
    CrossRefPubMed
  4. Cockcroft JR, Webb DJ, Wilkinson IB. Arterial stiffness, hypertension and diabetes mellitus. J Hum Hypertens. 2000; 14(6): 377–380.
    CrossRefPubMed
  5. Christensen T, Neubauer B, Christensen T, et al. Increased arterial wall stiffness and thickness in medium-sized arteries in patients with insulin-dependent diabetes mellitus. Acta Radiol. 1988; 29(3): 299–302.
    PubMed
  6. Alonso-Domínguez R, Sánchez-Aguadero N, Patino-Alonso M, et al. Association between measurements of arterial stiffness and target organ damage in a general Spanish population. Annals of Medicine. 2021; 53(1): 345–356.
    CrossRefPubMed
  7. Laurent S, Katsahian S, Fassot C, et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke. 2003; 34(5): 1203–1206.
    CrossRefPubMed
  8. Van Bortel LM, Laurent S, Boutouyrie P, et al. Artery Society, European Society of Hypertension Working Group on Vascular Structure and Function, European Network for Noninvasive Investigation of Large Arteries. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012; 30(3): 445–448.
    CrossRefPubMed
  9. Faconti L, Bruno RM, Ghiadoni L, et al. Ventricular and vascular stiffening in aging and hypertension. Curr Hypertens Rev. 2015; 11(2): 100–109.
    CrossRefPubMed
  10. Shahin Y, Khan JA, Chetter I. Angiotensin converting enzyme inhibitors effect on arterial stiffness and wave reflections: a meta-analysis and meta-regression of randomised controlled trials. Atherosclerosis. 2012; 221(1): 18–33.
    CrossRefPubMed
  11. Ong KT, Delerme S, Pannier B, et al. investigators. Aortic stiffness is reduced beyond blood pressure lowering by short-term and long-term antihypertensive treatment: a meta-analysis of individual data in 294 patients. J Hypertens. 2011; 29(6): 1034–1042.
    CrossRefPubMed
  12. Naqvi TZ, Lee MS. Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging. 2014; 7(10): 1025–1038.
    CrossRefPubMed
  13. Den Ruijter HM, Peters SAE, Anderson TJ, et al. Common carotid intima-media thickness measurements in cardiovascular risk prediction: a meta-analysis. JAMA. 2012; 308(8): 796–803.
    CrossRefPubMed
  14. Huang X, Zhang Y, Meng L, et al. Evaluation of carotid plaque echogenicity based on the integral of the cumulative probability distribution using gray-scale ultrasound images. PLoS One. 2017; 12(10): e0185261.
    CrossRefPubMed
  15. Carotid artery plaque composition--relationship to clinical presentation and ultrasound B-mode imaging. European Carotid Plaque Study Group. Eur J Vasc Endovasc Surg. 1995; 10(1): 23–30.
    CrossRefPubMed
  16. Genkel VV, Kuznetsova AS, Lebedev EV, et al. Factors associated with atherosclerotic plaque echogenicity in patients aged 40-64 with carotid atherosclerosis. Kardiologiia. 2021; 61(6): 35–40.
    CrossRefPubMed
  17. Lind L, Andersson J, Rönn M, et al. The echogenecity of the intima-media complex in the common carotid artery is closely related to the echogenecity in plaques. Atherosclerosis. 2007; 195(2): 411–414.
    CrossRefPubMed
  18. Jashari F, Ibrahimi P, Johansson E, et al. Carotid IM-GSM is better than IMT for identifying patients with multiple arterial disease. Scand Cardiovasc J. 2018; 52(2): 93–99.
    CrossRefPubMed
  19. Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med. 2020; 30(3): 160–164.
    CrossRefPubMed
  20. Mancia G, De Backer G, Dominiczak A, et al. ESH-ESC Task Force on the Management of Arterial Hypertension. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension. J Hypertens. 2007; 25(9): 1751–1762.
    CrossRefPubMed
  21. Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 1995; 92(5): 1355–1374.
    CrossRefPubMed
  22. Laurent S, Boutouyrie P, Laurent S, et al. Pathophysiology of hypertension in the elderly. Am J Geriatr Cardiol. 2002; 11(1): 34–39.
    CrossRefPubMed
  23. Sun Y, Liu F, Zhang Y, et al. The relationship of endothelial function and arterial stiffness with subclinical target organ damage in essential hypertension. J Clin Hypertens (Greenwich). 2022; 24(4): 418–429.
    CrossRefPubMed
  24. Duprez DA. Arterial stiffness and endothelial function: key players in vascular health. Hypertension. 2010; 55(3): 612–613.
    CrossRefPubMed
  25. Anderson TJ. Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk. Can J Cardiol. 2006; 22 Suppl B(Suppl B): 72B–80B.
    CrossRefPubMed
  26. Einarsen E, Gerdts E, Waje-Andreassen U, et al. Association of increased arterial stiffness with diastolic dysfunction in ischemic stroke patients: the Norwegian Stroke in the Young Study. J Hypertens. 2020; 38(3): 467–473.
    CrossRefPubMed
  27. Namba T, Masaki N, Matsuo Y, et al. Arterial Stiffness Is Significantly Associated With Left Ventricular Diastolic Dysfunction in Patients With Cardiovascular Disease. Int Heart J. 2016; 57(6): 729–735.
    CrossRefPubMed
  28. Yucel C, Demir S, Demir M, et al. Left ventricular hypertrophy and arterial stiffness in essential hypertension. Bratisl Lek Listy. 2015; 116(12): 714–718.
    CrossRefPubMed
  29. Seeland U, Brecht A, Nauman AT, et al. Prevalence of arterial stiffness and the risk of myocardial diastolic dysfunction in women. Biosci Rep. 2016; 36(5).
    CrossRefPubMed
  30. Urbina EM, Isom S, Dabelea D, et al. Association of Elevated Arterial Stiffness With Cardiac Target Organ Damage and Cardiac Autonomic Neuropathy in Young Adults With Diabetes: The SEARCH for Diabetes in Youth Study. Diabetes Care. 2023; 46(4): 786–793.
    CrossRefPubMed
  31. Bai Y, Wang Q, Cheng Di, et al. Comparison of Risk of Target Organ Damage in Different Phenotypes of Arterial Stiffness and Central Aortic Blood Pressure. Front Cardiovasc Med. 2022; 9: 839875.
    CrossRefPubMed
  32. Vasan RS, Short MI, Niiranen TJ, et al. Interrelations Between Arterial Stiffness, Target Organ Damage, and Cardiovascular Disease Outcomes. J Am Heart Assoc. 2019; 8(14): e012141.
    CrossRefPubMed
  33. Mitchell GF. Aortic stiffness, pressure and flow pulsatility, and target organ damage. J Appl Physiol (1985). 2018; 125(6): 1871–1880.
    CrossRefPubMed
  34. Mellucci PL, Bertanha M, Jaldin RG, et al. Grayscale median (GSM) post-processing, posterizing, and color mapping for carotid ultrasound. J Vasc Bras. 2023; 22: e20220081.
    CrossRefPubMed
  35. Jashari F, Ibrahimi P, Johansson E, et al. Carotid IM-GSM is related to multisite atherosclerosis disease. Atherosclerosis. 2015; 241(1): e164.
    CrossRef

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl