Increased carotid artery intimal-medial thickness: risk factor for exercise-induced myocardial ischemia in asymptomatic older individuals
| Autor: | Jerome L. Fleg, Yoji Nagai, E J Metter |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
Tunica media medicine.medical_specialty Carotid Artery Common Population Myocardial Ischemia 030204 cardiovascular system & hematology Asymptomatic Coronary artery disease Electrocardiography 03 medical and health sciences 0302 clinical medicine Reference Values Risk Factors Internal medicine medicine.artery Humans Medicine cardiovascular diseases 030212 general & internal medicine Common carotid artery Risk factor Radionuclide Imaging education Aged Ultrasonography education.field_of_study business.industry Carotid ultrasonography Heart Middle Aged medicine.disease Thallium Radioisotopes medicine.anatomical_structure Increased carotid artery intimal medial thickness Exercise Test cardiovascular system Cardiology Female medicine.symptom Tunica Intima Tunica Media Cardiology and Cardiovascular Medicine business |
| Zdroj: | Vascular Medicine. 4:181-186 |
| ISSN: | 1477-0377 1358-863X |
| DOI: | 10.1177/1358836x9900400309 |
| Popis: | Asymptomatic coronary artery disease (CAD) is prevalent in the general population and has been associated with an increased risk for symptomatic CAD. Although the diagnosis of asymptomatic CAD is currently dependent on exercise testing and coronary angiography, other vascular diagnostic techniques could potentially be of aid in the assessment. Increased intimal-medial thickness (IMT) of the common carotid artery as assessed by B-mode ultrasonography is a purported index of atherosclerosis, and is associated with symptomatic CAD. Based on a recent report, this article will focus on the relationship between IMT and asymptomatic CAD as evidenced by exercise ECG, and in combination with exercise thallium scintigraphy. It was found that exercise-induced ST segment depression was associated with increased IMT independent of age, coronary risk factors and manifest CAD. After adjustment for age, IMT progressively increased from healthy subjects to asymptomatic subjects with positive exercise ECG alone, to those with concordant positive ECG and thallium scintigraphic findings who had IMT virtually identical to that in subjects with manifest CAD. Each 0.1 mm increase in IMT was associated with a 1.91-fold (95% CI 1.46-2.50) increased risk for concordant positive exercise tests or manifest CAD, independent of other coronary risk factors. These findings and the review of the literature suggest the potential utility of carotid ultrasonography in identifying asymptomatic individuals at higher risk for CAD. |
| Databáze: | OpenAIRE |
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