Carotid IMT and Stiffness in the KiGGS 2 National Survey: Third-Generation Measurement, Quality Algorithms and Determinants of Completeness

Königstein, Karsten; Schenck, Ursula von; Büschges, Julia Charlotte; Schweizer, Dieter; Damerow, Stefan; Sarganas, Giselle; Dratva, Julia; Schmidt‐Trucksäss, Arno; Neuhauser, Hannelore

doi:10.1016/j.ultrasmedbio.2020.10.015

Cited by 7 publications

(14 citation statements)

References 54 publications

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“…Analyses were performed with STATA, Version A longitudinal weighting factor was applied to account for the clustered sample design, for drop-out and for deviations in the net sample from the population structure as described previously. 10 CIMT centiles were estimated separately for male and female participants, using the mean far wall CIMT of all available planes and generalized additive model for location, scale and shape, 8 a very flexible model class implemented in the gamlss package (Version 5.1-5; Stasinopoulos M. and Rigby B, 2019, http://gamlss.org) in R (Version 3.6.1; R Foundation for Statistical Computing, Wien, 2019, http://www.Rproject.org. To attenuate the influence of extreme outliers, data were winsorized before modeling, that is, values of male participants <(25th percentile value [pct]-3.0×interquartile range) and values >(75th pct + 4.3×interquartile range) were set to the named limits (limits in female participants: 25pct −3.2×interquartile range, 75pct +3.7×interquartile range).…”

Section: Discussionmentioning

confidence: 99%

“…9 The follow-up survey from 2014 until 2017 offered an examination part for those who still lived in the 167 communities by three mobile examination teams. A CIMT measurement was performed in 4709 participants aged 14 to 28 years, 10 that is, in a predominantly postpubertal sample. For the longitudinal analysis of this sample, detailed data was available from the baseline examination conducted in 2003 to 2006.…”

Section: Methodsmentioning

confidence: 99%

“…A detailed description of the sonographic procedure, automatic detection, real-time, and postprocedural quality control as well as a demonstration of the excellent methodological reliability is provided elsewhere. 10 Contours of the intimal-medial layer were automatically detected based on a sophisticated snake algorithm and subpixel interpolation. 13 Far wall CIMT was bilaterally measured in a 10 mm segment 10 to 15 mm proximal to the carotid bifurcation in the ear-to-ear and horizontal planes.…”

Section: Methodsmentioning

confidence: 99%

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Carotid Intima-Media Thickness Percentiles in Adolescence and Young Adulthood and Their Association With Obesity and Hypertensive Blood Pressure in a Population Cohort

et al. 2022

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Background: This study aimed to derive carotid intima media thickness (CIMT) percentiles from a population-based sample of adolescents and young adults using improved technology, standardization and quality control, and to investigate the association of CIMT with hypertensive blood pressure (BP) and obesity. Methods: Four thousand seven hundred nine 14- to 28-year-old participants of the German KiGGS cohort 11-year follow-up, which was based on a nationwide population sample, had B-mode ultrasound CIMT measurement with semi-automated edge-detection and automatic ECG-gated real-time quality control. CIMT percentiles were estimated from far wall CIMT during 2 to 6 heart cycles using the GAMLSS statistical model. Hypertensive BP, overweight, obesity, and a risk score from added Z scores of triglycerides, total/HDL (high-density lipoprotein)-cholesterol ratio, and HbA1c were based on standardized measurements at baseline and follow-up. Results: CIMT differed by sex at all ages, furthermore by age and height in a nonlinear fashion. Percentiles were estimated simultaneously by age and height. Hypertensive BP and obesity were associated cross-sectionally and longitudinally with a higher risk of CIMT ≥75th percentile in log-binomial regression models adjusted for age, sex, height, current smoking, and cardiovascular risk score. For CIMT ≥90th percentile, the relative risk effect estimates were consistently >1 but often had large confidence intervals including 1, largest adjusted relative risk 3.37 (95% CI, 1.41–8.04) for the combination of hypertensive BP and obesity at follow-up. Conclusions: Based on state-of-the-art measurements and statistical techniques, these population-based CIMT percentiles by sex, age and height add unbiased evidence for the association of subclinical atherosclerosis with hypertensive BP and obesity in the young.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Carotid Intima-Media Thickness Percentiles in Adolescence and Young Adulthood and Their Association With Obesity and Hypertensive Blood Pressure in a Population Cohort

et al. 2022

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“…Computation of cS parameters was possible when blood pressure as well as valid outer lumen diameter at peak systole and end diastole were available ( Figure 1 ). The equations used for calculation of distensibility coefficient, Young's elastic modulus, Peterson's elastic modulus and β-stiffness index as well as rates of completeness (89%) are presented in detail elsewhere ( 28 ).…”

Section: Methodsmentioning

confidence: 99%

“…Ultrasound examinations and data acquisition were performed semiautomatically using a portable state-of-the-art ultrasound system (UF-760AG, Fukuda Denshi Co. Ltd., Tokyo, Japan). Standard operating procedures, including computation of cIMT and cS parameters, adhered to current guidelines (26,27) and have been previously described in detail (28). Far wall common carotid IMT and outer lumen diameter were measured bilaterally in two planes (ear-to-ear and horizontal) within a 10 mm segment 10-15 mm proximal to the carotid bifurcation.…”

Section: Measurement Of Carotid Intima-media Thickness and Stiffnessmentioning

confidence: 99%

Exercise and Carotid Properties in the Young–The KiGGS-2 Study

Königstein

Büschges

Sarganas

et al. 2022

Front. Cardiovasc. Med.

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Background: Carotid intima-media thickness (cIMT) and stiffness (cS) are predictive markers of early vascular aging and atherosclerotic risk. This study assessed, whether exercise has protective effects on carotid structure and function or on vascular risk in the young.Methods: Volume and change of exercise (recreational and organized sports participation) of German adolescents and young adults was assessed within the prospective population-study KiGGS at KiGGS-Wave-1 (2009–2012) and KiGGS-Wave-2 (2014–2017) using standardized self-reporting questionnaires. CIMT and cS were measured by real-time B-mode ultrasound sequences with semi-automated edge-detection and automatic electrocardiogram-gated quality control in 2,893 participants (14–28 years, 49.6% female). A cumulative index for atherosclerotic risk (CV-R) included z-scores of mean arterial pressure, triglycerides, total/HDL-cholesterol-ratio, body mass index, and HbA1c.Results: At KiGGS-Wave-2 cross-sectional CV-R but not cS and cIMT was lower in all exercise-groups compared to “no exercise” (B = −0.73, 95%-CI = −1.26 to 0.19, p = 0.008). Longitudinal volume of exercise was negatively associated with CV-R (B = −0.37, 95%-CI = −0.74 to 0.00, p = 0.048) but not with cS and cIMT. Cross-sectional relative risk of elevated CV-R but not cS and cIMT was lower in all exercise-groups compared to “no exercise” (RR = 0.80, 95%-CI = 0.66 to 0.98, p = 0.033). High exercise volumes were associated with lower relative risk of elevated CV-R (RR = 0.80, 95%-CI = 0.65–0.97, p = 0.021) and cS in tendency but not with cIMT.Conclusions: Increased levels of exercise are associated with a better cardiovascular risk profile in young individuals, but not with cS and cIMT. Our study confirms previous recommendations on exercise in this age group without demonstrating a clear benefit on surrogate markers of vascular health.

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The Ultrasound Window Into Vascular Ageing: A Technology Review by the VascAgeNet COST Action

Bianchini

Guala

Golemati

et al. 2023

J of Ultrasound Medicine

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Non‐invasive ultrasound (US) imaging enables the assessment of the properties of superficial blood vessels. Various modes can be used for vascular characteristics analysis, ranging from radiofrequency (RF) data, Doppler‐ and standard B/M‐mode imaging, to more recent ultra‐high frequency and ultrafast techniques. The aim of the present work was to provide an overview of the current state‐of‐the‐art non‐invasive US technologies and corresponding vascular ageing characteristics from a technological perspective. Following an introduction about the basic concepts of the US technique, the characteristics considered in this review are clustered into: 1) vessel wall structure; 2) dynamic elastic properties, and 3) reactive vessel properties. The overview shows that ultrasound is a versatile, non‐invasive, and safe imaging technique that can be adopted for obtaining information about function, structure, and reactivity in superficial arteries. The most suitable setting for a specific application must be selected according to spatial and temporal resolution requirements. The usefulness of standardization in the validation process and performance metric adoption emerges. Computer‐based techniques should always be preferred to manual measures, as long as the algorithms and learning procedures are transparent and well described, and the performance leads to better results. Identification of a minimal clinically important difference is a crucial point for drawing conclusions regarding robustness of the techniques and for the translation into practice of any biomarker.

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Carotid IMT and Stiffness in the KiGGS 2 National Survey: Third-Generation Measurement, Quality Algorithms and Determinants of Completeness

Cited by 7 publications

References 54 publications

Carotid Intima-Media Thickness Percentiles in Adolescence and Young Adulthood and Their Association With Obesity and Hypertensive Blood Pressure in a Population Cohort

Carotid Intima-Media Thickness Percentiles in Adolescence and Young Adulthood and Their Association With Obesity and Hypertensive Blood Pressure in a Population Cohort

Exercise and Carotid Properties in the Young–The KiGGS-2 Study

The Ultrasound Window Into Vascular Ageing: A Technology Review by the VascAgeNet COST Action

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