Screening for subclinical atherosclerosis by noninvasive methods in asymptomatic patients with risk factors
Xavier Castellon1, Vera Bogdanova
1Department of Cardiology, Private Hospital Athis Mons, Paris, France. castellondelaplanaxavier@orange.fr
Insights
Screening for subclinical atherosclerosis using noninvasive imaging techniques like radio frequency (RF) measurement of intima-media thickness (RFQIMT) and arterial stiffness (RFQAS) is crucial for early detection. These methods help assess cardiovascular risk and improve long-term monitoring, reducing event occurrence.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- Atherosclerosis is a primary cause of cardiovascular mortality, exacerbated by risk factors like diabetes, obesity, and smoking.
- Sudden cardiac death is a major consequence of coronary artery disease, particularly in women.
- Primary prevention through screening is the only current strategy to reduce mortality in at-risk populations.
Purpose of the Study:
- To evaluate the relevance and efficacy of screening for subclinical atherosclerosis using novel noninvasive techniques.
- To assess the impact of risk factors on arterial remodeling and endothelial function before clinical manifestation.
- To demonstrate the reliability and reproducibility of noninvasive imaging for early atherosclerosis detection and patient monitoring.
Main Methods:
- Utilized radio frequency (RF) measurement of intima-media thickness (RFQIMT) and arterial stiffness (RFQAS).
- Employed flow-mediated vasodilatation (FMV) to assess endothelial function.
- Integrated these noninvasive techniques with two-dimensional echo since 2007 for detailed arterial wall analysis.
Main Results:
- Noninvasive techniques reliably detect subclinical atherosclerosis and assess arterial remodeling and endothelial function.
- These methods allow for the evaluation of pathological values related to intima-media thickness, pulse wave velocity, and endothelial dysfunction.
- Screening is justified in asymptomatic individuals with cardiovascular risk factors, including hypertension, diabetes, obesity, dyslipidemia, and smoking.
Conclusions:
- Noninvasive imaging is a reliable and reproducible tool for screening and early detection of subclinical atherosclerosis.
- This approach enables better monitoring of atherosclerosis progression and susceptibility in at-risk patients.
- Early detection and monitoring significantly contribute to reducing the long-term occurrence of cardiovascular events.
Abstract:
Atherosclerosis is a leading cause of cardiovascular death due to the increasing prevalence of the disease and the impact of risk factors such as diabetes, obesity or smoking. Sudden cardiac death is the primary consequence of coronary artery disease in 50% of men and 64% of women. Currently the only available strategy to reduce mortality in the at-risk population is primary prevention; the target population must receive screening for atherosclerosis. The value of screening for subclinical atherosclerosis is still relevant, it has become standard clinical practice with the emergence of new noninvasive techniques (radio frequency [RF] measurement of intima-media thickness [RFQIMT] and arterial stiffness [RFQAS], and flow-mediated vasodilatation [FMV]), which have been used by our team since 2007 and are based on detection marker integrators which reflect the deleterious effect of risk factors on arterial remodeling before the onset of clinical events. These techniques allow the study of values according to age and diagnosis of the pathological value, the thickness of the intima media (RFQIMT), the speed of the pulse wave (RFQAS), and the degree of endothelial dysfunction (FMV). This screening is justified in asymptomatic patients with cardiovascular risk factors (hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking). Studies conducted by RF coupled with two-dimensional echo since 2007 have led to a more detailed analysis of the state of the arterial wall. The various examinations allow an assessment of the degree of subclinical atherosclerosis and its impact on arterial remodeling and endothelial function. The use of noninvasive imaging in screening and early detection of subclinical atherosclerosis is reliable and reproducible and allows us to assess the susceptibility of our patients with risk factors and ensures better monitoring of atherosclerosis, thus reducing the occurrence of cardiovascular events in the long term.
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