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Perfil de riesgo cardiovascular en adultos jóvenes asintomáticos con grosor íntima media carotídeo elevado
Acevedo,Mónica; Kr?mer,Verónica; Tagle,Rodrigo; Arnaiz,Pilar; Corbalán,Ramón; Berríos,Ximena; Navarrete,Carlos;
Revista médica de Chile , 2011, DOI: 10.4067/S0034-98872011001000011
Abstract: background: cardiovascular risk factor (rf) assessment is essential to prevent and predict cardiovascular disease. the presence of rf at early ages, are determinant for the presence of atherosclerosis later in life. aim: to determine the rf profile of young subjects with high carotid intima media thickness (cimt). material and methods: we studied 689 subjects (50% women, mean age 36±6 years) from santiago, chile. we determined body mass index (bmi), waist circumference, blood pressure, fasting serum lipids, blood glucose and c-reactive protein. cimt was assessed by ultrasound using an automatic border recognition software. results: body mass index, waist circumference, blood pressure and serum lipids were significantly higher among subjects located in the higher cimt quartile. also, subjects in the higher quartile of cimt had a higher prevalence of three or more rf compared with the lower quartile (p = 0.01). finally, individuals with three or more rf showed three times more risk of being in the higher cimt quartile, than subjects with no rf (odds ratio = 3.1, p < 0.01). conclusions: there is a negative influence of cardiovascular rf on cimt among young subjects.
Hipertensión arterial: el factor de riesgo más importante para grosor íntima-media carotídeo elevado y placa carotídea en adultos de Santiago Risk factors for a high carotid intima media thickness among healthy adults
Mónica Acevedo,Rodrigo Tagle,Verónica Kramer,Pilar Arnaíz
Revista médica de Chile , 2011,
Abstract: Background: Carotid intima media thickness (CIMT) is a marker of cardiovascular damage that can be modified by traditional risk factors. Aim: To determine attributable risk factors for a high CIMT among healthy adults. Material ana Methods: A sample of 1270 individuáis (636 males and 634 femóles) aged 44 ±11 years, was studied. Blood pressure, weight, height, lipidprofile and blood glucose were measured in all. CIMT and thepresence of atheroscleroticplaques were determined by carotid ultrasound. Standard criteria were used to define hypertension, dyslipidemia and diabetes. Results: Mean CIMT in the sample studied was 0.62 ± 0.01 mm and percentile 75 was 0.67. The most important risk factor for a CIMT over percentile 75 and thepresence of atherosclerotic plaques was hypertension with attributable risks of 54 and 57%, respectively. Conclusions: In this sample, the main risk factor for a high CIMT was hypertension.
Puntuación de calcio coronario y grosor de íntima media carotídea en pacientes con sospecha de cardiopatía isquémica Coronary calcium score and thickness of carotid middle intima in patients with suspicion of ischemic heart disease  [cached]
Yudeisy Rodríguez Hernández,Vladimir Mendoza-Rodríguez,Luis Roberto Llerena Rojas,Eddy Wilder Olivares Aquiles
Revista Cubana de Investigaciones Biom??dicas , 2011,
Abstract: INTRODUCCIóN: El score de calcio coronario y la cuantificación del grosor de íntima media son métodos en desarrollo que se utilizan en el diagnóstico de aterosclerosis. OBJETIVO: Evaluar la relación del puntaje de calcio coronario con los factores de riesgo cardiovasculares clásicos y el grosor de la íntima media carotídea. MéTODOS: Se tomaron 70 pacientes con sospecha de cardiopatía isquémica. A todos se les cuantificó el calcio coronario por tomografía de 64 cortes y el grosor de íntima media en carótidas por ultrasonido. Usando la variable dependiente (score de calcio coronario) de forma continua, fue realizada una regresión lineal simple para obtener los coeficientes de regresión ( ). El nivel de significación estadística (a) con que se trabajó fue del 95 % (valor p < 0,05 como estadísticamente significativo). RESULTADOS: El puntaje de calcio fue superior en individuos del sexo masculino y se incrementó de manera lineal con el decursar de las décadas de edad, por cada a o que se incrementa la edad, aumenta en 11,4 UA el score de calcio. El coeficiente de correlación entre el score de calcio y la edad fue de 0,36 estadísticamente significativo (p= 0,002). El 88,9 % de los pacientes con grosor íntima media mayor de 1 mm tenían algún grado de calcificación coronaria, fue 2 veces mayor que los que presentaron un grosor de íntima media menor que 1 mm. El valor de la correlación (r) con el grosor de la íntima media carotídea fue de 0,24 (p= 0,04). CONCLUSIONES: La edad, el sexo masculino y el aumento del grosor íntima media carotídea se relacionan de manera significativa con la presencia y cuantía de la calcificación coronaria. INTRODUCTION: The coronary calcium's score and the quantification of media intima thickness are developing methods used in atherosclerosis diagnosis. OBJECTIVE: To assess the coronary calcium score relation to classic cardiovascular risk factors and the carotid media intima thickness. METHODS: Sample included 70 patients with suspicion of ischemic heart disease. In all of them the coronary calcium was quantified by 64 scans tomography and the media intima thickness by medias of ultrasound (US). Using continuously the dependent variable (coronary calcium score) we made a simple linear regression to obtain the regression coefficients ( ). The statistic significance level (a) used was of 95 % (value p < 0,05 as statistically significant). RESULTS: Calcium score was higher in male sex subjects increasing linearly and annually with age in 11.4 UA. The correlation coefficient between calcium score and age was of 0.36 statistically signif
Grosor de íntima-Media Carotídea en Ni os Sanos por Técnica Ecográfica Computarizada Arterial intima-media thickness in healthy Chilean children using an ultrasonographic computerized technique
ANIBAL ESPINOZA G,CATALINA BAGéS M,CATALINA LE ROY O,CARLOS CASTILLO D
Revista chilena de pediatría , 2011,
Abstract: Introducción: Uno de los sitios de da o asociado a síndrome metabólico es el endotelio vascular; la medición ecográfica del grosor de intima-media carotídea (GIMC) es usado en adultos como un indicador de da o vascular, pero no se conocen valores de normalidad en ni os. Objetivo: Estudiar el grosor de intima-media carotídea mediante programa computacional específico, en ni os chilenos sanos. Pacientes y Método: Se seleccionaron 72 ni os (percentiles 10-85 de IMC sin enfermedad conocida), 5 a 15 a os de edad, de estratos socioeconómicos medio-altos, 33 ni as y 39 varones, agrupados por tramos de edad; se les efectuó y promedió 3 mediciones ecográficas en tercio medio de arteria carótida común derecha, mediante equipo Phillips modelo íU22; se usó un transductor lineal 12-5 MHz y un software de cuantificación avanzada QLAB, con programa específico de medición automática para grosor de GlMC Además se les midió: peso, talla, 1MC, perímetro abdominal (PA). Se solicitó previamente el consentimiento escrito a padres y ni os. Resultados: No hubo diferencias en las mediciones de GlMC de acuerdo a edad o sexo, la mediana fue de 0,41 mm (0,40-0,56 mm); hubo 5 ni os entre 0,50 y 0,56 mm (> percentil 75); no hubo correlación con PA o 1MC; los ni os con PA < percentil 50 tuvieron una mediana de GlMC igual a aquellos con PA > percentil 50 (0,41 mm). Conclusiones: Las mediciones de grosor de intima-media carotídea de ni os y adolescentes chilenos sanos mediante técnica ecográfica y programa computarizado, están dentro de valores esperados para la edad, comparados con valores conocidos de adultos. Introduction: Vascular endothelium is a target organ in metabolic syndrome. Ultrasound measurement of intimae-media thickness (IMT) is used in adults to predict cardiovascular risk, but normal values in children are unknown. Objective: To describe arterial intima-media thickness in healthy children, by means of an ultrasonographic technique and a specific software. Subjects and Methods: Seventy-four healthy children, 39 males, ages 5-15 y.o., body mass index (BMI) 10-85 percentile were selected from an upper-middle socioeconomic background. Subjects were grouped by age. Three measurements were carried out to each subject at the middle third of the right common carotid for maximal intima-media thickness using a Phillips iU22 ultrasound system; a 12-5 MHz lineal transducer and QLAB advanced quantification software, which includes a specific program for automated IMT measurements, were used. Weight, stature, BMI, and abdominal circumference were registered. Results: No significant
Modificación del grosor intima-media carotídeo según factores de riesgo clásicos y síndrome metabólico con o sin inflamación Relation of Intima-Media Thickness, traditional Risk Factors and Metabolic Syndrome in subjects with or with inflammation
Mónica Acevedo,Pilar Arnaíz,Ramón Corbalán,Iván Godoy
Revista Chilena de Cardiología , 2009,
Abstract: El grosor intima-media carotideo (CIMT) es un marcador de aterosclerosis subclinica y eventos isquémicos cerebrales y coronarios. Si bien los valores normales promedio en Chile, han sido publicados, no existen datos locales de cómo se modifica el CIMT según la carga de factores de riesgo (FR) cardiovascular. Objetivos: Analizar la modificación del CIMT según la carga de FR clásicos, presencia de síndrome metabólico (SMET) y SMET más inflamación. Métodos: Hombres y mujeres de Santiago sin antecedente de eventos isquémicos previos, nivel socio económico medio, medio bajo y medio alto. En todos se realizó encuesta sobre antecedentes demográficos, FR cardiovascular, y medición de PA, IMC, cintura, y perfil lipídico, glicemia y proteína C-reactiva ultrasensible (ePCR) en ayuno. Para diagnóstico de SMET se usó NCEP ATPIII (2001), y para inflamación, ePCR> 2 mg/L (valor de corte de > riesgo porAHA). El CIMT se midió en carótida común derecha e izquierda con software MATH . Resultados: Se incluyeron en el análisis 999 sujetos (508 hombres), edad promedio 43.8±11 a os. La prevalencia de HTA fue 30%, dislipidemia 68%, tabaquismo 47%, y SMET 24%. El CIMT medio promedio fue 0.61±0.1 mm y la ePCR promedio 2.22 mg/L. La modificación del CIMT medio (mm) según número de FR (edad>45/55 hombre/mujer, diabetes, HTA, colesterol total > 200, HDL < 40/50, tabaquismo e historia familiar), fue la siguiente: 0 FR= 0.55 ± 0.08; 1-2 FR= 0.59 ± 0.091; ≥ 3 FR= 0.67 ± 0.12 (p < 0.0001). Asimismo, el CIMT aumentó según el puntaje de Framingham: < 5% = 0.58 ± 0.09; 5-10%= 0.66 ± 0.11; > 10-20%= 0.68 ± 0.11; >20% > o = 0.76 ± 0.14 (p < 0.0001). El CIMT fue significativamente mayor en los sujetos con SMET, y se incrementa en forma significativa cuando se adiciona ePCR>2 mg/L. En el modelo de regresión múltiple, el CIMT se asocia en forma conjunta a Framingham (p < 0.0001) y SMET+ePCR>2 (p=0.01) (r2=0.19 para modelo). Conclusión: El CIMT aumenta según la carga de FR clásicos y en sujetos que presentan SMET. El aumento significativo de CIMT en los sujetos con SMET e inflamación (ePCR>2), sugiere un aumento del riesgo aterosclerótico en ellos que deberá ser confirmado en estudios prospectivos con medición de eventos. Este estudio confirma la utilidad del CIMT para cuantificar carga de FR. Carotid intima-media thickness (CIMT) is a marker for cerebral and coronary ischemic events. Normal values for CIMT in Chile have been published but the relation of CIMT to level of risk factors (RF) is unknown. Aim. To analyze the relation of CIMT to level of traditional RF and the presence of metabolic s
Grosor de la íntima-media de la arteria carótida en adolescentes obesos y su relación con el síndrome metabólico Intima-media thickness in obese adolescents and their relation with metabolic syndrome
C. Torrejón,M. Hevia,E. Ureta,X. Valenzuela
Nutrición Hospitalaria , 2012,
Abstract: Introducción: Los adolescentes obesos presentan mayor riesgo cardiovascular (RCV). La medición del grosor de la intima-media (GIM) arterial detecta tempranamente el compromiso vascular. Objetivo: Evaluar si los adolescentes obesos tienen mayor compromiso vascular medido por GIM que los adolescentes no obesos, y si este es mayor en aquellos con síndrome metabólico (SM). Metodología: Grupo estudio (GE), ni os obesos, IMC/edad > p95, con y sin SM y grupo control, IMC/edad p10-85, sin patología nutricional ni endocrina. Se midieron concentraciones séricas de lípidos, prueba tolerancia oral a glucosa con insulinemia y ecografía de arteria carótida. Para evaluar diferencia entre grupos se utilizaron pruebas estadísticas paramétricas y no paramétricas. Resultados: Se evaluaron 45 adolescentes obesos (20 mujeres), 19 con SM, edad 13 (9-16) a os y 18 controles (14 mujeres), edad 13 (11-16) a os. GIM del bulbo carotideo y de la arteria carótida interna (ACI) fueron significativamente mayores en GE que grupo control (0,54 vs 0,34; 0,34 vs 0,25, p < 0,05). No hubo diferencia entre grupos de obesos. GIM de bulbo y de ACI se correlacionaron positivamente con zIMC (r = 0,3 y 0,6; p < 0,05) y circunferencia de cintura (CC) (r = 0,3 y 0,55; p < 0,05). GIM de ACI se correlacionó positivamente con insulinemia en ayunas, HOMA y presión arterial sistólica. En el análisis multivariado solo el IMC y CC se asociaron independientemente al GIM. Conclusión: La obesidad es un factor de riesgo temprano de da o cardiovascular medido por GIM y el GIM de la ACI demostró tener mayor correlación con los factores de RCV. Introduction: Obese adolescents have higher cardiovascular risk (CVR). Intima-media thickness (IMT) detects early arterial vascular compromise. Objective: To evaluate whether obese adolescents have higher vascular compromise measured by IMT than nonobese adolescents, and if this is greater in those with metabolic syndrome (MS). Method: The study group (SG), obese children (BMI/age > p95), with and without MS and control group (CG), non-obese (BMI/age p10-85) and non nutritional or endocrine disease. We measured serum lipids, oral glucose tolerance test with insulin and carotid artery ultrasound. To evaluate the differences between test groups we used parametric and nonparametric statistics. Results: We evaluated 45 obese adolescents (20 women), 19 with MS, age 13 (9-16) years and 18 controls (14 women), aged 13 (11-16) years. IMT of carotid bulb and internal carotid artery (ICA) were significantly higher in SG than CG (0.54 vs. 0.34, 0.34 vs. 0.25, p < 0.05). There was n
Hipertensión arterial: el factor de riesgo más importante para grosor íntima-media carotídeo elevado y placa carotídea en adultos de Santiago
Acevedo,Mónica; Tagle,Rodrigo; Kramer,Verónica; Arnaíz,Pilar; Marín,Arnaldo; Pino,Felipe; Godoy,Iván; Berríos,Ximena; Navarrete,Carlos;
Revista médica de Chile , 2011, DOI: 10.4067/S0034-98872011000300002
Abstract: background: carotid intima media thickness (cimt) is a marker of cardiovascular damage that can be modified by traditional risk factors. aim: to determine attributable risk factors for a high cimt among healthy adults. material ana methods: a sample of 1270 individuáis (636 males and 634 femóles) aged 44 ±11 years, was studied. blood pressure, weight, height, lipidprofile and blood glucose were measured in all. cimt and thepresence of atheroscleroticplaques were determined by carotid ultrasound. standard criteria were used to define hypertension, dyslipidemia and diabetes. results: mean cimt in the sample studied was 0.62 ± 0.01 mm and percentile 75 was 0.67. the most important risk factor for a cimt over percentile 75 and thepresence of atherosclerotic plaques was hypertension with attributable risks of 54 and 57%, respectively. conclusions: in this sample, the main risk factor for a high cimt was hypertension.
Carotid intima-media thickness as a surrogate marker of cardiovascular disease in diabetes  [cached]
Latika Sibal,Sharad C Agarwal,Philip D Home
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy , 2011,
Abstract: Latika Sibal1, Sharad C Agarwal2, Philip D Home21Wolfson Diabetes and Endocrine Clinic, Addenbrooke's Hospital, Cambridge, UK; 2Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UKBackground: Diabetes mellitus is associated with a high risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is increasingly used as a surrogate marker for atherosclerosis. Its use relies on its ability to predict future clinical cardiovascular end points.Methods: This review examines the evidence linking CIMT as a surrogate marker of vascular complications in people with type 1 and type 2 diabetes. We have also reviewed the various treatment strategies which have been shown to influence CIMT.Conclusions: CIMT measurement is an effective, noninvasive tool which can assist in identifying people with diabetes who are at higher risk of developing microvascular and macrovascular complications. It may also help to evaluate the effectiveness of various treatment strategies used to treat people with diabetes.Keywords: carotid, intima-media thickness, CIMT, diabetes
Endothelial Dysfunction and Brachial Intima-Media Thickness: Long Term Cardiovascular Risk with Claudication Related to Peripheral Arterial Disease: A Prospective Analysis  [PDF]
Franz Hafner, Andrea Kieninger, Andreas Meinitzer, Thomas Gary, Harald Froehlich, Elke Haas, Gerald Hackl, Philipp Eller, Marianne Brodmann, Gerald Seinost
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0093357
Abstract: Objective Endothelial dysfunction plays a key role in the development, progression, and clinical manifestation of atherosclerosis, and in symptomatic peripheral arterial disease, endothelial dysfunction and enlarged intima-media thickness might be associated with increased cardiovascular risk. Flow-mediated dilatation and serologic parameters are used to evaluate individual endothelial function. Brachial intima-media thickness, a less recognized parameter of cardiovascular risk, is independently associated with coronary artery disease. The aim of this study was to evaluate the prognostic value of ultrasound and serologic parameters of endothelial function in relation to cardiovascular mortality in peripheral arterial disease. Design monocentric, prospective cohort study. Methods Flow mediated dilatation and brachial intima-media thickness were assessed in 184 (124 male) patients with peripheral arterial disease (Rutherford stages 2–3). Serologic parameters of endothelial function included asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-homoarginine. Cardiovascular events were recorded during a follow-up of 99.1±11.1 months. Subjects who died of noncardiovascular causes were excluded from further analysis. Results Eighty-two patients (44.6%) died during follow-up after a mean duration of 49.7±28.3 months. There were 49 cardiovascular deaths (59.8%) and 33 other deaths (40.2%). Flow mediated dilatation was associated with cardiovascular death [1.17% (0.0, 4.3) vs. 4.1% (1.2, 6.4), p<0.001]. Intima-media thickness was greater in patients who succumbed to cardiovascular disease [0.37 mm (0.30, 0.41)] than in survivors [0.21 mm (0.15, 0.38), p<0.001]. Brachial intima-media thickness above 0.345 mm was most predictive of cardiovascular death, with sensitivity and specificity values of 0.714 and 0.657, respectively (p<0.001). Furthermore, ADMA levels above 0.745 μmol/l and SDMA levels above 0.825 μmol/l were significantly associated with cardiovascular death (p<0.001 and 0.030). Conclusion In symptomatic peripheral arterial disease, decreased flow mediated dilatation, enlarged intima-media thickness, and elevated levels of ADMA and SDMA were associated with increased cardiovascular risk.
Carotid intima-media thickness as a surrogate marker of cardiovascular disease in diabetes
Latika Sibal, Sharad C Agarwal, Philip D Home
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy , 2011, DOI: http://dx.doi.org/10.2147/DMSO.S8540
Abstract: rotid intima-media thickness as a surrogate marker of cardiovascular disease in diabetes Review (5712) Total Article Views Authors: Latika Sibal, Sharad C Agarwal, Philip D Home Published Date January 2011 Volume 2011:4 Pages 23 - 34 DOI: http://dx.doi.org/10.2147/DMSO.S8540 Latika Sibal1, Sharad C Agarwal2, Philip D Home2 1Wolfson Diabetes and Endocrine Clinic, Addenbrooke's Hospital, Cambridge, UK; 2Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Background: Diabetes mellitus is associated with a high risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is increasingly used as a surrogate marker for atherosclerosis. Its use relies on its ability to predict future clinical cardiovascular end points. Methods: This review examines the evidence linking CIMT as a surrogate marker of vascular complications in people with type 1 and type 2 diabetes. We have also reviewed the various treatment strategies which have been shown to influence CIMT. Conclusions: CIMT measurement is an effective, noninvasive tool which can assist in identifying people with diabetes who are at higher risk of developing microvascular and macrovascular complications. It may also help to evaluate the effectiveness of various treatment strategies used to treat people with diabetes.
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