Mannheim Carotid Intima-Media Thickness Consensus (2004–2006)

Abstract

Intima-media thickness (IMT) is increasingly used as a surrogate end point of vascular outcomes in clinical trials aimed at determining the success of interventions that lower risk factors for atherosclerosis and associated diseases (stroke, myocardial infarction and peripheral artery diseases). The necessity to promote further criteria to distinguish early atherosclerotic plaque formation from thickening of IMT and to standardize IMT measurements is expressed through this updated consensus. Plaque is defined as a focal structure that encroaches into the arterial lumen of at least 0.5 mm or 50% of the surrounding IMT value or demonstrates a thickness >1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. Standard use of IMT measurements is based on physics, technical and disease-related principles as well as agreements on how to perform, interpret and document study results. Harmonization of carotid image acquisition and analysis is needed for the comparison of the IMT results obtained from epidemiological and interventional studies around the world. The consensus concludes that there is no need to ‘treat IMT values’ nor to monitor IMT values in individual patients apart from exceptions named, which emphasize that inside randomized clinical trials should be performed. Although IMT has been suggested to represent an important risk marker, according to the current evidence it does not fulfill the characteristics of an accepted risk factor. Standardized methods recommended in this consensus statement will foster homogenous data collection and analysis. This will help to improve the power of randomized clinical trials incorporating IMT measurements and to facilitate the merging of large databases for meta-analyses.

An Update on the Role of Markers of Inflammation in Atherosclerosis

“…The Mannheim Carotid Intima-Media Thickness Consensus recommends the following definitions for ultrasound characterization of IMT and atherosclerotic plaque: (1) IMT is a double-line pattern visualized by echotomography on both walls of the CCAs in a longitudinal image. It is formed by two parallel lines, which consist of the leading edges of two anatomical boundaries: the lumen−intima and media−adventitia interfaces; (2) Plaque is a focal structure encroaching into the arterial lumen by at least 0.5 mm or 50% of the surrounding IMT value, or demonstrates a thickness of 1.5 mm as measured from the media−adventitia interface to the intima-lumen interface 11) .…”

Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study

“…The CIMT was calculated by placing a cursor at two points on the posterior wall of an approximately 10 mm segment of the artery. The proximal starting point was 1 cm from the bulb of the CCA [49,50]. The instrument software automatically captures the distance of the intima–media interface as the CIMT measurement.…”

Rotinas de organizacao de exames e entrevistas no centro de investigacao ELSA-Brasil

“…Second blood collection -120 minutes after consumption of 50% glucose solution in non-diabetic participants (16)(17)(18) or standard snack in diabetic participants. [3][4][5]8 Pulse wave velocity estimation Measured using a non-invasive validated device (Complior SP, Artech Medicale France).…”

“…Images were measured in a workstation with the IMAGE ARENA -TOM TEC software ® . 18 Hepatic steatosis assessment obtained from a wide-band convex transducer (PVT -375BT), with a central frequency of 3.5 MHz (2.5 -5.5 MHz) -Toshiba, SSA-770A -APLIO ® (Tokyo, Japan). Images were measured in a workstation with the IMAGE ARENA -TOM TEC software ® .…”