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Can single cIMT measurement during echocardiography affect further investigation decision for coronary artery
Alper Ö Karaçalıoğlu1, Semra İnce, Özdeş Emer
1Department of Nuclear Medicine, Gülhane Military Medical Academy and School of Medicine, Ankara-Turkey. aokaracali@gata.edu.tr.
Insights
Carotid intima-media thickness (cIMT) measured during echocardiography does not aid in deciding further tests for suspected coronary artery disease (CAD). While cIMT predicts cardiovascular events, it
Area of Science:
- Cardiology
- Diagnostic Imaging
- Vascular Ultrasound
Background:
- Coronary artery disease (CAD) diagnosis relies on various imaging modalities.
- Carotid intima-media thickness (cIMT) is a marker of subclinical atherosclerosis.
- Echocardiography is a common cardiac diagnostic tool.
Purpose of the Study:
- To assess if measuring cIMT during echocardiography influences decisions for further CAD evaluation.
- To determine the utility of cIMT in guiding referral for gated myocardial perfusion imaging (gMPI).
Main Methods:
- Carotid intima-media thickness (cIMT) was measured in 199 patients during echocardiography.
- All patients subsequently underwent gated myocardial perfusion imaging (gMPI).
- Patients were categorized into CAD and normal groups based on gMPI results and into four subgroups by cIMT levels.
Main Results:
- A significant correlation was observed between age and cIMT (r=0.546, p<0.001).
- CAD group showed higher cIMT (0.74±0.17 mm) than the normal group (0.67±0.16 mm, p=0.012).
- Age-corrected cIMT and categorical cIMT values did not show significant differences or strong correlations with CAD presence.
Conclusions:
- Single cIMT measurement during echocardiography is not a reliable tool for decision-making in suspected CAD.
- While cIMT can predict cardiovascular events, its role in guiding further diagnostic workup in this context is limited.
- gated myocardial perfusion imaging (gMPI) remains a key diagnostic tool for suspected coronary artery disease.
Objective:
This study was aimed to evaluate whether there is any potential role of the measurement of the carotid intima-media thickness (cIMT) in patients with suspected coronary artery disease (CAD) during the echocardiography session on decision-making to refer patients for further diagnostic evaluation such as gated myocardial perfusion imaging (gMPI).
Methods:
cIMT of 199 consecutive patients was measured during the echocardiography session and all patients underwent gMPI. According to gMPI results, patients were divided into two groups as CAD and normal groups and according to cIMT measurements patients were divided into four subgroups.
Results:
Although, there was a good correlation between the age and cIMT values of the patients (r=0.546, p<0.001), the correlation between the summed stress scores and the age of the patients was very weak (r=0.142, p=0.045) and the correlation between the summed stress scores and the cIMT values was very weak (r=0.107, p=0.131). The cIMT measurements of the CAD group (0.74±0.17 mm) were significantly higher than those of the normal group (0.67±0.16 mm) (p=0.012), but after the age correction, the significance between the cIMT measurements of the CAD and the normal groups was not found (p=0.131). Besides, the relationship between the categorical cIMT values of both the CAD and the normal groups was insignificant (p=0.059) and the correlation between the increasing cIMT values and the presence of detectable CAD was also very weak (r=0.187, p=0.08).
Conclusion:
cIMT can predict occurrence of cardiovascular events in subjects, but single cIMT measurement during echocardiographic examination does not seem to have potential role on decision making for further investigation in patients with suspected CAD.
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