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Published online: 2020-03-11
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Carotid intima-media thickness (IMT) in patients with severe familial and non-familial hypercholesterolemia: The effect of measurement site on the IMT correlation with traditional cardiovascular risk factors and calcium scores

Rafal Gałąska, Dorota Kulawiak-Gałąska, Magdalena Chmara, Krzysztof Chlebus, Agnieszka Mickiewicz, Andrzej Rynkiewicz, Bartosz Wasąg, Michał Studniarek, Marcin Fijałkowski, Marcin Gruchała
DOI: 10.5603/CJ.a2020.0032
·
Pubmed: 32207844

open access

Ahead of print
Original articles
Published online: 2020-03-11

Abstract

Background: The carotid intima–media thickness (IMT) measurement may be carried out proximally (pIMT) or distally (dIMT) in relation to the bulb of the common carotid artery which has significant implications on the results and correlation with risk factors. The aim of the study was to compare the pIMT and dIMT in patients with familial hypercholesterolemia confirmed by genetic testing (FH group) and patients with severe non-familial hypercholesterolemia, with negative results of genetic testing (NFH group) and to determine the correlation of results with traditional atherosclerotic risk factors and calcium scores.

Methods: A total of 86 FH and 50 NFH patients underwent pIMT and dIMT measurements of both carotid arteries as well as computed tomography (CT) with coronary and thoracic aorta calcium scoring.

Results: The meanpIMT of both right and left common carotid artery were significantly higher in patients with FH compared to the NFH group (meanpRIMT 0.721 ± 0.152 vs. 0.644 ± 0.156, p < 0.01, meanpLIMT 0.758 ± 0.173 vs. 0.670 ± 0.110, p < 0.01). Patient age, pre-treatment low-density lipoprotein (LDL) cholesterol levels (LDLmax) at baseline and systolic blood pressure were independent predictors of pIMT increases in both carotid arteries. Smoking history age and LDLmax were independent predictors of dIMT increase. There was a significant correlation between the calcium scores of the ascending aorta, coronary artery and aortic valve and all IMT parameters.

Conclusions: The IMT measured proximally was better differentiated between patients with familial and non-familial hypercholesterolemia. The association between IMT and traditional cardiovascular risk factors varies between measurement sites. IMT values correlate CT calcium scores in all patients with hypercholesterolaemia regardless of genetic etiology.

Abstract

Background: The carotid intima–media thickness (IMT) measurement may be carried out proximally (pIMT) or distally (dIMT) in relation to the bulb of the common carotid artery which has significant implications on the results and correlation with risk factors. The aim of the study was to compare the pIMT and dIMT in patients with familial hypercholesterolemia confirmed by genetic testing (FH group) and patients with severe non-familial hypercholesterolemia, with negative results of genetic testing (NFH group) and to determine the correlation of results with traditional atherosclerotic risk factors and calcium scores.

Methods: A total of 86 FH and 50 NFH patients underwent pIMT and dIMT measurements of both carotid arteries as well as computed tomography (CT) with coronary and thoracic aorta calcium scoring.

Results: The meanpIMT of both right and left common carotid artery were significantly higher in patients with FH compared to the NFH group (meanpRIMT 0.721 ± 0.152 vs. 0.644 ± 0.156, p < 0.01, meanpLIMT 0.758 ± 0.173 vs. 0.670 ± 0.110, p < 0.01). Patient age, pre-treatment low-density lipoprotein (LDL) cholesterol levels (LDLmax) at baseline and systolic blood pressure were independent predictors of pIMT increases in both carotid arteries. Smoking history age and LDLmax were independent predictors of dIMT increase. There was a significant correlation between the calcium scores of the ascending aorta, coronary artery and aortic valve and all IMT parameters.

Conclusions: The IMT measured proximally was better differentiated between patients with familial and non-familial hypercholesterolemia. The association between IMT and traditional cardiovascular risk factors varies between measurement sites. IMT values correlate CT calcium scores in all patients with hypercholesterolaemia regardless of genetic etiology.

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Keywords

atherosclerosis, familial hypercholesterolemia, intima–media thickness, calcium scores, multidetector computed tomography

About this article
Title

Carotid intima-media thickness (IMT) in patients with severe familial and non-familial hypercholesterolemia: The effect of measurement site on the IMT correlation with traditional cardiovascular risk factors and calcium scores

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Research paper

Published online

2020-03-11

DOI

10.5603/CJ.a2020.0032

Pubmed

32207844

Keywords

atherosclerosis
familial hypercholesterolemia
intima–media thickness
calcium scores
multidetector computed tomography

Authors

Rafal Gałąska
Dorota Kulawiak-Gałąska
Magdalena Chmara
Krzysztof Chlebus
Agnieszka Mickiewicz
Andrzej Rynkiewicz
Bartosz Wasąg
Michał Studniarek
Marcin Fijałkowski
Marcin Gruchała

References (25)
  1. O'Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999; 340(1): 14–22.
  2. Chambless LE, Heiss G, Folsom AR, et al. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993. Am J Epidemiol. 1997; 146(6): 483–494.
  3. Piepoli MF, Hoes AW, Brotons C, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016; 37(29): 2315–2381.
  4. Lorenz MW, Markus HS, Bots ML, et al. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007; 115(4): 459–467.
  5. Lavrencic A, Kosmina B, Keber I, et al. Carotid intima-media thickness in young patients with familial hypercholesterolaemia. Heart. 1996; 76(4): 321–325.
  6. Kusters D, Wiegman A, Kastelein J, et al. Carotid Intima-Media Thickness in Children With Familial Hypercholesterolemia. Circ Res. 2014; 114(2): 307–310.
  7. Wiegman A, de Groot E, Hutten BA, et al. Arterial intima-media thickness in children heterozygous for familial hypercholesterolaemia. Lancet. 2004; 363(9406): 369–370.
  8. Kornet L, Lambregts J, Hoeks AP, et al. Differences in near-wall shear rate in the carotid artery within subjects are associated with different intima-media thicknesses. Arterioscler Thromb Vasc Biol. 1998; 18(12): 1877–1884.
  9. Iglesias del Sol A, Bots ML, Grobbee DE, et al. Carotid intima-media thickness at different sites: relation to incident myocardial infarction; The Rotterdam Study. Eur Heart J. 2002; 23(12): 934–940.
  10. Hollander M, Hak AE, Koudstaal PJ, et al. Comparison between measures of atherosclerosis and risk of stroke: the Rotterdam Study. Stroke. 2003; 34(10): 2367–2372.
  11. Iana Simova,. Intima-media thickness: Appropriate evaluation and proper measurement, described. E-journal of the ESC Council for Cardiology Practice 2015; Vol. 13, N° 21.
  12. Polak JF, Post WS, Carr JJ, et al. Associations of common carotid intima-media thickness with coronary heart disease risk factors and events vary with distance from the carotid bulb. J Am Soc Echocardiogr. 2014; 27(9): 991–997.
  13. Galaska R, Kulawiak-Galaska D, Wegrzyn A, et al. Assessment of Subclinical Atherosclerosis Using Computed Tomography Calcium Scores in Patients with Familial and Nonfamilial Hypercholesterolemia. J Atheroscler Thromb. 2016; 23(5): 588–595.
  14. Gałąska R, Kulawiak-Gałąska D, Chmara M, et al. Aortic valve calcium score in hypercholesterolemic patients with and without low-density lipoprotein receptor gene mutation. PLoS One. 2018; 13(12): e0209229.
  15. Stein JH, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr. 2008; 21(2): 93–111; quiz 189.
  16. Willekes C, Brands PJ, Willigers JM, et al. Assessment of local differences in intima-media thickness in the human common carotid artery. J Vasc Res. 1999; 36(3): 222–228.
  17. Kornet L, Lambregts J, Hoeks AP, et al. Differences in near-wall shear rate in the carotid artery within subjects are associated with different intima-media thicknesses. Arterioscler Thromb Vasc Biol. 1998; 18(12): 1877–1884.
  18. Nerem RM. Vascular fluid mechanics, the arterial wall, and atherosclerosis. J Biomech Eng. 1992; 114(3): 274–282.
  19. Sun Yu, Lin CH, Lu CJ, et al. Carotid atherosclerosis, intima media thickness and risk factors: an analysis of 1781 asymptomatic subjects in Taiwan. Atherosclerosis. 2002; 164(1): 89–94.
  20. Arad Y, Spadaro LA, Roth M, et al. Correlations between vascular calcification and atherosclerosis: a comparative electron beam CT study of the coronary and carotid arteries. J Comput Assist Tomogr. 1998; 22(2): 207–211.
  21. Cohen GI, Aboufakher R, Bess R, et al. Relationship between carotid disease on ultrasound and coronary disease on CT angiography. JACC Cardiovasc Imaging. 2013; 6(11): 1160–1167.
  22. Kathiresan S, Larson MG, Keyes MJ, et al. Assessment by cardiovascular magnetic resonance, electron beam computed tomography, and carotid ultrasonography of the distribution of subclinical atherosclerosis across Framingham risk strata. Am J Cardiol. 2007; 99(3): 310–314.
  23. Wolski C, Rotkiewicz A, Grzelak P, et al. Comparison of tomographic coronary artery calcification index (calcium score) and ultrasonographic measurement of intima-media complex thickness in diabetic subjects. Pol J Radiol. 2011; 76(4): 15–20.
  24. Davis PH, Dawson JD, Mahoney LT, et al. Increased carotid intimal-medial thickness and coronary calcification are related in young and middle-aged adults. The Muscatine study. Circulation. 1999; 100(8): 838–842.
  25. Polak JF, Post WS, Carr JJ, et al. Associations of common carotid intima-media thickness with coronary heart disease risk factors and events vary with distance from the carotid bulb. J Am Soc Echocardiogr. 2014; 27(9): 991–997.

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