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Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment.

Publication ,  Journal Article
Polak, JF; Meisner, A; Pencina, MJ; Wolf, PA; D'Agostino, RB
Published in: J Am Soc Echocardiogr
September 2012

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.

Duke Scholars

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

September 2012

Volume

25

Issue

9

Start / End Page

1023 / 1028

Location

United States

Related Subject Headings

  • Videotape Recording
  • Systole
  • Risk Factors
  • Risk Assessment
  • Regression Analysis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography
 

Citation

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ICMJE
MLA
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Polak, J. F., Meisner, A., Pencina, M. J., Wolf, P. A., & D’Agostino, R. B. (2012). Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment. J Am Soc Echocardiogr, 25(9), 1023–1028. https://doi.org/10.1016/j.echo.2012.05.007
Polak, Joseph F., Allison Meisner, Michael J. Pencina, Philip A. Wolf, and Ralph B. D’Agostino. “Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment.J Am Soc Echocardiogr 25, no. 9 (September 2012): 1023–28. https://doi.org/10.1016/j.echo.2012.05.007.
Polak JF, Meisner A, Pencina MJ, Wolf PA, D’Agostino RB. Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment. J Am Soc Echocardiogr. 2012 Sep;25(9):1023–8.
Polak, Joseph F., et al. “Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment.J Am Soc Echocardiogr, vol. 25, no. 9, Sept. 2012, pp. 1023–28. Pubmed, doi:10.1016/j.echo.2012.05.007.
Polak JF, Meisner A, Pencina MJ, Wolf PA, D’Agostino RB. Variations in common carotid artery intima-media thickness during the cardiac cycle: implications for cardiovascular risk assessment. J Am Soc Echocardiogr. 2012 Sep;25(9):1023–1028.
Journal cover image

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

September 2012

Volume

25

Issue

9

Start / End Page

1023 / 1028

Location

United States

Related Subject Headings

  • Videotape Recording
  • Systole
  • Risk Factors
  • Risk Assessment
  • Regression Analysis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography