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Updated: Jun 19, 2026
Murine Echocardiography and Ultrasound Imaging
Published on: August 9, 2010
Ultrasound imaging techniques for the evaluation of cardiovascular therapies
John J P Kastelein1, Eric de Groot
1Department of Vascular Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. j.j.kastelein@amc.uva.nl
Insights
New therapies for cardiovascular disease are needed to reduce residual risk. Vascular ultrasound imaging techniques, like carotid intima-media thickness (CIMT) and intravascular ultrasound (IVUS), can accelerate drug development using surrogate endpoints.
Area of Science:
- Cardiology
- Medical Imaging
- Pharmacology
Background:
- Cardiovascular disease (CVD) is a leading cause of death globally, with significant residual risk despite current treatments.
- Developing novel therapies to mitigate this residual risk is a critical healthcare objective.
- Traditional clinical trials for new CVD therapies are lengthy due to the need for statistically significant clinical event data.
Purpose of the Study:
- To review the rationale and evidence for using vascular ultrasound imaging techniques as surrogate endpoints in cardiovascular drug development.
- To highlight the potential of surrogate endpoints to expedite the assessment of novel cardiovascular therapies.
- To discuss the application of carotid intima-media thickness (CIMT) and intravascular ultrasound (IVUS) in clinical trials.
Main Methods:
- Review of historical and recent clinical trials utilizing vascular ultrasound imaging.
- Analysis of the role of carotid intima-media thickness (CIMT) measurements.
- Evaluation of intravascular ultrasound (IVUS) data from coronary artery assessments.
Main Results:
- Vascular ultrasound techniques (CIMT and IVUS) are increasingly employed in surrogate endpoint trials for cardiovascular therapies.
- These surrogate endpoints offer a means to assess therapeutic efficacy earlier than traditional clinical endpoints.
- The use of CIMT and IVUS can potentially shorten the drug development timeline for new cardiovascular treatments.
Conclusions:
- Carotid intima-media thickness (CIMT) and intravascular ultrasound (IVUS) serve as valuable surrogate endpoints in cardiovascular research.
- These imaging biomarkers can significantly accelerate the evaluation of novel cardiovascular therapies.
- Utilizing surrogate endpoints in drug development is crucial for addressing the unmet need for effective treatments for residual cardiovascular risk.
Abstract:
Cardiovascular disease remains a substantial cause of morbidity and mortality in the developed world, and is becoming an increasingly important cause of death in developing countries too. While current cardiovascular treatments can help to reduce this disease burden, a substantial number of patients still retain a high risk of experiencing a life-threatening cardiovascular event. Thus, the development of new therapies capable of reducing this residual risk remains an important healthcare objective. The time taken to bring new therapies to the patient in need is lengthened by the unavoidable requirement to demonstrate a statistically significant benefit in terms of clinical events beyond that achievable with current treatments. However, clinical trials utilizing surrogate endpoints-biomarkers of disease progression that manifest before potentially fatal cardiovascular events occur-have the potential to enhance the process of drug development by enabling a statistically sound assessment of the efficacy of new therapies several years in advance of the availability of data from clinical endpoint trials. Two vascular ultrasound imaging techniques, measurement of carotid intima-media thickness (CIMT) and intravascular ultrasound (IVUS) of the coronary arteries, are increasingly being used to assess novel cardiovascular therapies in surrogate endpoint trials forming integral components of larger trial programmes utilizing both surrogate and clinical endpoints. The rationale for the use of CIMT- and IVUS-based surrogates, with supporting evidence from historical and recent trials, is presented in this review article.
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