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Updated: Sep 30, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Ultrasonic tissue characterization of the carotid artery in chronic renal failure patients
Marco Rossi1, Adamasco Cupisti, Gino Santoro
1Department of Internal Medicine, University of Pisa, Italy. mrossi@int.med.unipi.it
Insights
Integrated backscatter (IBS) analysis reveals increased carotid wall reflectivity in chronic renal failure (CRF) patients, even without overt atherosclerosis. This suggests IBS can detect early vascular changes in CRF.
Area of Science:
- Vascular Biology
- Nephrology
- Medical Imaging
Background:
- Ultrasonic reflectivity, measured by integrated backscatter (IBS), is a potential prognostic marker for atherosclerotic diseases.
- Chronic renal failure (CRF) is associated with increased cardiovascular risk, but early vascular changes are not always clinically evident.
Purpose of the Study:
- To evaluate carotid wall ultrasonic reflectivity using IBS analysis in patients with chronic renal failure (CRF).
- To determine if IBS can detect early arterial wall changes in CRF patients independent of overt atherosclerosis.
Main Methods:
- B-mode ultrasound and IBS analysis of the carotid wall were performed on 30 CRF patients and 30 healthy controls.
- CRF patients included normotensives (NT) and treated hypertensives (TH); cardiovascular complications were absent.
Main Results:
- The IBS carotid index was significantly higher in CRF patients compared to controls (31.7 +/- 3.5 vs. 28.9 +/- 2.3 dB; p < 0.001).
- No significant difference in IBS was found between NT and TH CRF patients.
- IBS index showed a negative correlation with low-density lipoprotein cholesterol levels (r = -0.46, p < 0.05) and, in TH patients, with body mass index and diastolic blood pressure.
- Carotid intima-media thickness was similar between CRF patients and controls.
Conclusions:
- Carotid ultrasonic reflectivity is increased in CRF patients, suggesting vascular remodeling linked to CRF, independent of atherosclerotic damage.
- IBS analysis is a valuable tool for detecting early structural changes in the arterial wall.
- Further prospective studies are needed to establish the prognostic significance of IBS in uremic patients.
Abstract:
The ultrasonic reflectivity of the carotid wall, measured by means of integrated backscatter (IBS) analysis, has recently been evaluated in patients with atherosclerotic diseases and it was considered to be a prognostic marker. We performed B-mode measurement and IBS analysis of the carotid wall in 30 chronic renal failure (CRF) patients (serum creatinine 548 +/- 230 micromol/l) on conservative treatment and free of clinical evidence of cardiovascular complications; 14 were normotensives (NT) and 16 were treated hypertensives (TH). Thirty sex- and age-matched healthy subjects served as controls. The IBS carotid index was significantly higher in CRF patients than in controls (31.7 +/- 3.5 vs. 28.9 +/- 2.3 dB; p < 0.001), and no difference was observed between TH and NT CRF patients. The IBS index was negatively correlated with low-density lipoprotein cholesterol plasma levels (r = -0.46, p < 0.05), and within the group of TH CRF patients the IBS index was also negatively correlated with the body mass index and diastolic blood pressure. The carotid intima-media thickness was similar between uremic patients and controls. This study demonstrates an increment in carotid ultrasonic reflectivity in CRF patients, independent of the presence of overt atherosclerotic damage, and probably related to vascular remodelling linked to CRF. IBS analysis can be a useful tool to detect early changes in arterial wall structure. However, prospective studies should be planned to define its prognostic importance in uremic patients.
