Carotid Intima-Media Thickness and Plaque Assessment by Trained Medical Residents: Validation and Preliminary Testing of a Training Protocol

Aldridge, Michael E.; Do, Khuyen; Oo, Thiri; Naqvi, Tasneem Z.

doi:10.1016/j.echo.2013.08.009

Cited by 14 publications

(8 citation statements)

References 20 publications

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“…On the other hand, our results do not suggest an important impact regarding the operator's experience. Specific and fast training protocols may improve IMT agreement even with inexperienced operators [30] suggesting that highly experienced sonographers might not significantly differ from less trained operators. However, more dedicated designs are required to achieve more reliable conclusions on zooming or experience, even more considering that experience has been previously related with disagreements [29,31].…”

Section: Discussionmentioning

confidence: 99%

Carotid intima-media thickness and hemodynamic parameters: reproducibility of manual measurements with Doppler ultrasound

et al. 2015

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Aims: To evaluate the carotid ultrasound intra-and interobserver agreements in a common clinical scenario when making manual measurements of the intima-media thickness (IMT) and peak systolic (PSV) and end diastolic (EDV) velocities in the common (CCA) and the internal carotid (ICA) arteries. Material and methods: Three different experienced operators performed two time-point carotid ultrasounds in 21 patients with cardiovascular risk factors. Each operator measured freehand the CCA IMT three consecutive times in each examination. The CCA and ICA hemodynamic parameters were acquired just once. . Intraobserver agreements were fair-moderate for PSVs and good-excellent for EDVs. Interobserver agreements were good-excellent for both PSVs and EDVs. Overall, 95% confidence intervals were narrower for the left IMTmean and CCA velocities. Conclusions: Intra and interobserver agreements in carotid ultrasound are variable. In order to improve carotid IMT agreements, IMTmean is preferable over IMTmax.

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Section: Discussionmentioning

confidence: 99%

Carotid intima-media thickness and hemodynamic parameters: reproducibility of manual measurements with Doppler ultrasound

et al. 2015

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“…Carotid plaque has incremental value to cIMT in risk assessment. Carotid ultrasound is relatively easy to use and can be applied to daily practice given the widespread availability of ultrasound devices [51].…”

Section: Clinical Outcomesmentioning

confidence: 99%

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation

Vlachopoulos¹,

Xaplanteris²,

Aboyans³

et al. 2015

Atherosclerosis

659

482

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While risk scores are invaluable tools for adapted preventive strategies, a significant gap exists between predicted and actual event rates. Additional tools to further stratify the risk of patients at an individual level are biomarkers. A surrogate endpoint is a biomarker that is intended as a substitute for a clinical endpoint. In order to be considered as a surrogate endpoint of cardiovascular events, a biomarker should satisfy several criteria, such as proof of concept, prospective validation, incremental value, clinical utility, clinical outcomes, cost-effectiveness, ease of use, methodological consensus, and reference values. We scrutinized the role of peripheral (i.e. not related to coronary circulation) noninvasive vascular biomarkers for primary and secondary cardiovascular disease prevention. Most of the biomarkers examined fit within the concept of early vascular aging. Biomarkers that fulfill most of the criteria and, therefore, are close to being considered a clinical surrogate endpoint are carotid ultrasonography, ankle-brachial index and carotid-femoral pulse wave velocity; biomarkers that fulfill some, but not all of the criteria are brachial ankle pulse wave velocity, central haemodynamics/wave reflections and C-reactive protein; biomarkers that do no not at present fulfill essential criteria are flow-mediated dilation, endothelial peripheral arterial tonometry, oxidized LDL and dysfunctional HDL. Nevertheless, it is still unclear whether a specific vascular biomarker is overly superior. A prospective study in which all vascular biomarkers are measured is still lacking. In selected cases, the combined assessment of more than one biomarker may be required.

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“…Therefore, it is important to improve assessment of subclinical vascular disease – especially in subjects with an intermediate risk according to established risk prediction models [2, 3]. Measuring carotid intima-media thickness (CIMT) via B-mode ultrasound presents a widely accepted, noninvasive, sensitive and reproducible technique to quantify subclinical vascular disease [2, 4, 5]. It is accepted that CIMT at three different locations, i.e.…”

Section: Introductionmentioning

confidence: 99%

Segment-specific association of carotid-intima-media thickness with cardiovascular risk factors – findings from the STAAB cohort study

Müller-Scholden

Kirchhof

Morbach

et al. 2019

BMC Cardiovasc Disord

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Background The guideline recommendation to not measure carotid intima-media thickness (CIMT) for cardiovascular risk prediction is based on the assessment of just one single carotid segment. We evaluated whether there is a segment-specific association between different measurement locations of CIMT and cardiovascular risk factors. Methods Subjects from the population-based STAAB cohort study comprising subjects aged 30 to 79 years of the general population from Würzburg, Germany, were investigated. CIMT was measured on the far wall of both sides in three different predefined locations: common carotid artery (CCA), bulb, and internal carotid artery (ICA). Diabetes, dyslipidemia, hypertension, smoking, and obesity were considered as risk factors. In multivariable logistic regression analysis, odds ratios of risk factors per location were estimated for the endpoint of individual age- and sex-adjusted 75th percentile of CIMT. Results 2492 subjects were included in the analysis. Segment-specific CIMT was highest in the bulb, followed by CCA, and lowest in the ICA. Dyslipidemia, hypertension, and smoking were associated with CIMT, but not diabetes and obesity. We observed no relevant segment-specific association between the three different locations and risk factors, except for a possible interaction between smoking and ICA. Conclusions As no segment-specific association between cardiovascular risk factors and CIMT became evident, one simple measurement of one location may suffice to assess the cardiovascular risk of an individual.

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Carotid Intima-Media Thickness and Plaque Assessment by Trained Medical Residents: Validation and Preliminary Testing of a Training Protocol

Cited by 14 publications

References 20 publications

Carotid intima-media thickness and hemodynamic parameters: reproducibility of manual measurements with Doppler ultrasound

Carotid intima-media thickness and hemodynamic parameters: reproducibility of manual measurements with Doppler ultrasound

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation

Segment-specific association of carotid-intima-media thickness with cardiovascular risk factors – findings from the STAAB cohort study

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