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Carotid artery intima-media thickness measurements in the youth: reproducibility and technical considerations

Elif Seda Selamet Tierney1, Kimberlee Gauvreau2, Michael R Jaff3

  • 1Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|December 3, 2014
PubMed

Insights

Standardizing carotid artery intima-media thickness (CIMT) measurements in youth is crucial for cardiovascular disease research. Electrocardiographic timing improves reproducibility, highlighting the need for consistent pediatric study protocols.

Area of Science:

  • Pediatric cardiovascular research
  • Medical imaging analysis
  • Atherosclerosis research

Background:

  • Carotid artery intima-media thickness (CIMT) is a key indicator of atherosclerosis in at-risk youth.
  • Standardization of CIMT measurement methodology in pediatric studies is currently limited.
  • Existing pediatric studies have utilized CIMT as a primary outcome, necessitating reliable measurement techniques.

Purpose of the Study:

  • To evaluate the reproducibility of CIMT measurements in children and adolescents.
  • To compare two distinct CIMT measurement techniques: optimal cardiac cycle timing (Opt-CIMT) and R-wave timing (R-CIMT).
  • To assess interobserver variability in CIMT measurements.

Main Methods:

  • Retrospective analysis of carotid artery ultrasound studies from 184 pediatric subjects.
  • CIMT measurements were performed by sonographers using Opt-CIMT and R-CIMT methods.
  • Independent observers remeasured studies to assess interobserver and intraobserver reproducibility for both methods.

Main Results:

  • Both Opt-CIMT and R-CIMT demonstrated excellent reproducibility (intraclass correlation coefficients > 0.85).
  • R-CIMT measurements were significantly thicker than Opt-CIMT measurements in both right and left common carotid arteries (P < .001).
  • Interobserver variability was high for both methods, but R-CIMT showed slightly better reproducibility for the left CCA.

Conclusions:

  • Pediatric CIMT measurements exhibit excellent reproducibility when consistent methodology is applied.
  • Significant variations in CIMT measurements occur throughout the cardiac cycle.
  • Standardization of CIMT measurement, particularly using electrocardiographic R-wave timing, is recommended for pediatric longitudinal studies.
Abstract

Keywords:
AtherosclerosisCarotid artery IMTCarotid artery ultrasoundReproducibilityVariabilityYouth

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