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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of peripheral vascular disease (PVD) in diabetic patients is manyfold higher than that of age- and sex-matched nondiabetic subjects. This study was designed to evaluate the relationship between quantitatively determined peripheral circulation in the lower extremities and arterial wall thickness or stiffness in 68 patients with type 2 diabetes. Peripheral circulation during treadmill-exercise was monitored by transcutaneous oxygen tension (TcPO2) and was expressed as percentage of post-exercise TcPO2 adjusted by that of pre-exercise (TcPO2 index). Arterial wall thickness (intima-media thickness; IMT) and stiffness (stiffness beta) were measured by ultrasonography. TcPO2 index was negatively (r=-0.350, P=0.0007) correlated with stiffness beta, not with IMT, of the femoral artery. In patients without insulin therapy (n=52), both fasting plasma insulin concentration (r=-0.323, P=0.0023) and HOMA IR, an insulin resistance index, (r=-0.281, P=0.0084) were negatively correlated with TcPO2 index. Multiple regression analyses showed that association of stiffness beta of the femoral artery or HOMA IR with the TcPO2 index was independent of other factors including age, smoking index, ankle brachial pressure index and IMT of femoral artery. Thus, arterial wall stiffness of femoral artery appears to be a major determinant of peripheral circulation in patients with type 2 diabetes.
Atherosclerosis 2003 Sep
PMID:Arterial wall stiffness is associated with peripheral circulation in patients with type 2 diabetes. 1295 86

The aim of the present study was to investigate the independent association of the intimal-medial thickness of carotid and femoral arteries (CA-IMT and FA-IMT), a marker of atheroscelosis, with insulin resistance in type 2 diabetic patients. We evaluated CA-IMT and FA-IMT by high-resolution ultrasonography and insulin resistance determined by euglycemic hyperinsulinemic clamp in 119 type 2 diabetic subjects, 71 males and 48 females (age, 54 +/- 12 (SD) years). In simple regression analyses, CA-IMT and FA-IMT were significantly inversely correlated with insulin sensitivity index (CA-IMT, r = -0.225, p = 0.010; FA-IMT, r = -0.186, p = 0.043, respectively). Multiple regression analysis was performed with the logarithm of CA-IMT or FA-IMT as a dependent variable and insulin sensitivity index as an independent variable along with known clinical risk factors. Insulin sensitivity index exhibited a significant independent contribution to log (CA-IMT) (beta = -0.204, p = 0.033) and to log (FA-IMT) (beta = -0.237, p = 0.010) in these models (CA-IMT, R(2) = 0.347, p < 0.0001; FA-IMT, R(2) = 0.398, p < 0.0001, respectively). In conclusion, insulin resistance is associated with both CA-IMT and FA-IMT in type 2 diabetic patients, suggesting that it is an independent risk factor for the development of atherosclerosis in type 2 diabetes.
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PMID:Arterial wall thickness is associated with insulin resistance in type 2 diabetic patients. 1456 88

Atherosclerosis, as a chronic inflammatory condition, can be mediated by immunological reactions. Therefore, it is possibly related to a specific antigen. Because autoimmunological reactions occur during atherogenesis, it is possible that alpha-actin expression induces a specific autoimmune reaction. We determined whether the intima-media (IMT) and adventitial thickness (AT) of carotid arteries, assessed by an ultrasound method, correlate with the level of anti-actin autoantibodies (AAA) in human serum. The study involved a group of 128 patients (66 women and 62 men). The mean age was 65.0 (+/- 7.9) years. Fifty-four patients had suffered an ischaemic stroke, whereas the remaining (as controls) had no history of cerebrovascular disease. High-resolution ultrasonography was used to evaluate the IMT and AT of their common carotid arteries. The mean carotid IMT was 0.95 (+/- 0.36) mm and the mean AT was 0.94 (+/- 0.20) mm. There was a significant correlation between carotid AT and the AAA serum level (r = 0.20; p = 0.024). However, there was no association between the mean IMT and AAA serum levels in the carotid arteries (r = 0.08; p = 0.328). In this preliminary (in vivo) study, we found that the level of AAA correlated positively with ultrasonographically assessed AT during carotid atherosclerosis.
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PMID:Serum autoantibodies to actin are associated with carotid artery wall adventitial thickness assessed using B-mode ultrasound. 1460 95

Atherosclerosis has two key components, thickening and stiffening of arterial wall. These parameters are quantified ultrasonographically by IMT (intima-media thickness) and PWV (pulse wave velocity). In the present study, we determined the FA IMT (IMT of the bilateral femoral artery) and PWV of femoral-ankle (PWV fa) and brachial-ankle (PWV ba) segments in order to examine whether the degree of atherosclerosis is different between paretic and non-paretic lower limbs in 24 patients with hemiparesis. The values of PWV fa, PWV ba and FA IMT were all significantly greater on the paretic than the non-paretic side. Furthermore, significant decreases in masses of muscle, bone and fat, determined by dual-energy X-ray absorptiometry, were observed in paretic lower limbs compared with the non-paretic side. PWV fa correlated significantly and negatively with muscle mass ( r =-0.488, P =0.0004) and tended to correlate negatively with BMC (bone mineral content; r =-0.264, P =0.069) when statistical analyses were performed with the paretic and non-paretic sides together. Multiple regression analysis elucidated that the muscle mass was associated significantly with PWV fa and PWV ba, independent of age, duration after cerebrovascular accident, gender, bone and fat mass and FA IMT. The muscle mass was still associated with increased PWV fa and PWV ba when multivariate analysis was conducted independently in the paretic and non-paretic sides. In summary, our results indicated that arterial thickening and stiffening were greater on the paretic than the non-paretic side and suggested that a decrease of muscle mass might be associated with increased arterial stiffening in the paretic lower limb.
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PMID:Increased arterial stiffening and thickening in the paretic lower limb in patients with hemiparesis. 1476 Dec 47

An increase in the intima-media thickness of the common carotid artery (CCA-IMT) is generally considered as an early marker of atherosclerosis and has been associated with a higher risk of stroke and myocardial infarction. There is no evidence of an association between the IMT and cerebral bleeding. We investigated cross-sectionally the diagnostic ability of vascular risk factors, including CCA-IMT, to distinguish between brain infarction (BI) and intracerebral haemorrhage (ICH). Patients suffering from BI (n = 126) had significantly (p < 0.05) higher CCA-IMT when compared to the ICH population (n = 30). The multinomial logistic regression procedure selected CCA-IMT as an independent factor able to discriminate between BI and ICH. The risk of BI versus ICH increased continuously with increasing CCA-IMT. After adjustment for cardiovascular risk factors the odds ratio for BI per 0.1 mm CCA-IMT increase was 1.29 (95% CI: 1.03-1.61). The present results demonstrate the possible predictive power of non-invasive measurement of the CCA-IMT with respect to BI versus ICH and deserve further investigation.
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PMID:Common carotid artery intima-media thickness in patients with brain infarction and intracerebral haemorrhage. 1502 10

Diabetes mellitus and the metabolic syndrome (MS) are reaching epidemic proportions in the United States, and cardiovascular disease continues to be the leading cause of death among patients with diabetes. A range of noninvasive screening tools may help reduce the morbidity and mortality of patients with diabetes because of early detection of subclinical cardiovascular disease and active monitoring of the effectiveness of therapy. Surrogate markers of subclinical disease include conventional and contrast-enhanced ultrasound imaging of carotid artery intima-media thickness (c-IMT), 2-dimensional echocardiography, coronary artery calcium imaging, cardiac magnetic resonance imaging, ankle-brachial indices, and brachial artery reactivity testing. Because these noninvasive imaging tools are relatively comfortable and entail relatively low risk to the patient, they are ideal for initial screening and for the repeated imaging that is required for monitoring the effectiveness of therapy. Moreover, when used in large numbers of patients with diabetes, prediabetes, and the MS, these imaging tools may be useful in developing and validating thresholds for the use of lipid-lowering therapy as well as clear therapeutic goals for this population. In addition, contrast-enhanced c-IMT scans now produce real-time images of the vasa vasorum and neovascularization of atherosclerotic plaque, potentially causing a paradigm shift in our view of the genesis of atherosclerosis and affecting treatment options for all populations. Thus, surrogate markers may not only help improve individual patient outcomes, they also may help direct scarce medical resources to maximize medical benefits, improve overall medical care, and minimize costs and untoward side effects.
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PMID:Role of surrogate markers in assessing patients with diabetes mellitus and the metabolic syndrome and in evaluating lipid-lowering therapy. 1517 15

Recent reports suggested that lipocalin-type prostaglandin D synthase (L-PGDS) is implicated in atherogenesis. In the present study, we investigated the polymorphism of the L-PGDS gene and examined its relationship with the severity of carotid atherosclerosis which is determined as the maximum intima-media thickness in the common carotid artery (C-IMT(max)). We identified 6 single nucleotide polymorphisms (SNPs) of the L-PGDS gene in Japanese. A rare SNP with an amino acid change (1535C>G in exon 4, Leu79Val) and a common SNP (4111 A>C in 3'-untranslated region) were selected for genotyping in 782 Japanese hypertensive subjects. There was no significant difference among genotypes in 1535C>G, however, in 4111 A>C, serum levels of high-density lipoprotein (HDL) cholesterol were significantly higher in subjects with A/A genotype than those with A/C and C/C genotypes. C-IMT(max) was significantly smaller in subjects with A/A genotype than those with A/C and C/C. Logistic regression analysis revealed that the presence of A/A genotype significantly reduced the risk for increased C-IMT(max), even after adjustment for other known risk factors [adjusted odds ratio: 0.71 (95% CI: 0.58-0.88)]. Our results suggested that 4111 A>C polymorphism in the L-PGDS gene contributes to the development of carotid atherosclerosis in Japanese hypertensive patients.
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PMID:Identification of gene polymorphism in lipocalin-type prostaglandin D synthase and its association with carotid atherosclerosis in Japanese hypertensive patients. 1532 47

It has been shown that common carotid intima-media thickness (CCA-IMT) is a useful outcome measure in clinical studies and intervention trials reflecting early stage of atherosclerosis and cardiovascular risk. The present study examined the association between CCA-IMT and incident ischemic stroke and its subtypes in 75 cases and 21 controls. Cases with ischemic brain infarctions (IBI) were consecutively recruited and classified into subtypes by CT and Bamford's classification (the size and site of infarct) like total anterior circulation infarcts (TACIs), partial anterior circulation infarcts (PACIs), posterior circulation infarcts (POCIs) or lacunar infarcts (LACIs). Controls were recruited among individuals hospitalized at the same institutions and matched for age and sex. Patients and control subjects underwent B-mode ultrasonographic measurements of IMT of the distal wall of both common carotid arteries. Of 75 patients with an acute ischemic stroke, 10 (14%) were classified as TACIs, 34 (45%) with PACIs, 12 (16%) with POCIs and 19 (25%) with LACIs. Mean CCA-IMT was higher in cases (1.03+/-0.18 mm) than in controls (0.85+/-0.18 mm; p<0.0001). The difference in CCA-IMT between cases and controls was significant and the relation between CCA-IMT and IBI remained after adjustment for main cardiovascular risk factors. Regarding the subtypes of IBI, IMT values were significantly higher in patients with TACIs and PACIs versus those with LACIs and POCIs. An increased CCA-IMT was associated with the all subtypes IBI and was significantly higher in those with anterior circulation infarcts versus posterior circulation and lacunar infarcts.
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PMID:Intima-media thickness of common carotid artery, carotid atherosclerosis and subtypes of ischemic cerebral disease. 1552 5

Observational studies suggested that the progression of carotid atherosclerosis and plaques might be an independent risk factor for coronary artery disease (CAD) and stroke, prior researches of different dosage of statins therapy on the progression of carotid atherosclerosis in patients had small sample sizes and different the results. We aimed to evaluate the efficacy and safety of statins therapy on the rate of carotid atherosclerosis progression through randomized controlled trials (RCTs). We searched MEDLINE (1980-September 2003), the Cochrane Controlled Trials Register, EMBASE (1985-September 2003), Science Citation Index and PUBMED (updated through December 2003). Additional articles were obtained from reference lists of relevant reviews and papers in manual searches. Ten studies (eight studies between statins and placebo, two studies between aggressive statins and conventional therapy) were included. Two reviewers extracted abstracts, and appraised the Jadad Score for Grading Quality of Randomized Controlled Trials independently, and discrepancies were resolved by consensus with a third reviewer. We analyzed the 10 trials with 3443 individuals age range from 30 to 70 years old and follow-up for 1-4 years. Eight studies showed that the rates of carotid IMT progression were consistently significantly different between statins and placebo, the Z score for overall effect of IMT was 10.41 (P<0.00001), Total 95%CI of weighted mean difference (WMD) between two groups was -0.02235 [-0.02656, -0.01614] (mm/y), the chi(2)-test for heterogeneity of IMT between eight studies was 685.33 (P<0.00001), two studies between aggressive statins and conventional statins demonstrated that the Z score for overall effect of IMT was 15.85 (P<0.00001), total 95%CI of WMD between two groups was -0.06326 [-0.07108, -0.05544], chi(2)-test for heterogeneity of IMT between two studies was 3.75 (P=0.05). Conventional statins were not significantly different of adverse events and withdrawal than placebo (P>0.05). Our findings suggest that conventional statins therapy are efficient and safe to decrease the rate of carotid atherosclerosis progression in a long-term, and aggressive statins may provide superior efficacy for carotid atherosclerosis regression.
Atherosclerosis 2004 Dec
PMID:Effects of statin therapy on the progression of carotid atherosclerosis: a systematic review and meta-analysis. 1553 Sep 20

Although it is often recommended to standardize the time of day when performing non-invasive measurements of vascular function, the exact influence of the time of day on the outcome of IMT (intima-media thickness), PWV (pulse wave velocity), AIX (augmentation index) and FMD (flow-mediated dilatation) measurements has not been reported before. Nineteen healthy volunteers visited our department on two different occasions: the first visit was at 09:00 hours after an overnight fast, and the second visit was at 14:00 hours after a standardized breakfast. Non-invasive measurements of atherosclerosis were performed twice at 09:00 hours and once on the second visit at 14:00 hours. Measurement of IMT, PWV, AIX and FMD was reproducible according to the method of Bland and Altman. The absolute difference between repeated measurements at 09:00 hours showed no significant difference compared with the absolute difference between 09:00 and 14:00 hours for IMT (0.029+/-0.014 compared with 0.021+/-0.014 mm; P = 0.27), PWV (0.63+/-0.50 compared with 0.75+/-0.74 m/s; P = 0.52), AIX (4.0+/-4.0 compared with 5.5+/-5.2%; P = 0.35) and FMD (3.8+/-3.7 compared with 4.2+/-2.9%; P = 0.70). In conclusion, our results show that, in healthy volunteers during the daytime, IMT, PWV, AIX and FMD outcomes are not confounded by variation in the exact time of the examination as long as other (exogenous) conditions, including food intake, smoking and intake of alcohol, are carefully controlled for.
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PMID:Variation in non-invasive measurements of vascular function in healthy volunteers during daytime. 1563 80


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