Carotid IM-GSM is better than IMT for identifying patients with multiple arterial disease
Fisnik Jashari1, Pranvera Ibrahimi1, Elias Johansson1,2
1a Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden.
Insights
Intima media-grey scale median (IM-GSM) effectively identifies multiple arterial territories affected by atherosclerosis, unlike conventional intima media thickness (IMT). This ultrasound marker shows promise for monitoring widespread atherosclerotic vascular disease.
Area of Science:
- Vascular Biology
- Medical Imaging
- Cardiovascular Disease
Background:
- Atherosclerosis is a systemic inflammatory condition affecting multiple arteries.
- Early detection and monitoring of multi-arterial involvement are crucial for patient outcomes.
Purpose of the Study:
- To investigate the relationship between ultrasound markers of atherosclerosis in the carotid artery and the presence of disease in multiple arterial beds.
- To evaluate if intima media thickness (IMT) and intima media-grey scale median (IM-GSM) can predict multi-arterial disease.
Main Methods:
- Eighty-seven asymptomatic carotid disease patients were analyzed.
- Intima media thickness (IMT) and intima media-grey scale median (IM-GSM) were measured in the common carotid artery (CCA).
- Measurements were correlated with existing atherosclerotic disease in coronary, carotid, and lower extremity arteries.
Main Results:
- Patients with coronary artery disease showed higher IMT and lower IM-GSM.
- Prior stroke correlated with lower IM-GSM.
- IM-GSM significantly decreased with an increasing number of affected arterial territories (p < .001).
- Conventional IMT did not show significant differences between groups (p = .49).
Conclusions:
- IM-GSM is a more sensitive marker than conventional IMT for detecting multi-arterial territory atherosclerosis.
- IM-GSM can differentiate the extent of arterial involvement, making it a valuable tool for monitoring disease progression.
Objective:
Atherosclerosis is a systemic inflammatory disease that can affect more than one arterial bed simultaneously. The aim of this study was to determine the relationship between ultrasound markers of atherosclerosis and multiple arterial disease.
Design:
We have included 87 currently asymptomatic carotid disease patients (mean age 69 ± 6 year, 34% females) in this study. Intima media thickness (IMT) and intima media-grey scale median (IM-GSM) were measured in the common carotid artery (CCA), and correlated with previous and/or current atherosclerotic vascular disease in the coronary, carotid and lower extremities. Patients were divided into three groups: (1) asymptomatic, (2) previous symptoms in one arterial territory and (3) previous symptoms in multiple arterial territories.
Results:
Patients with previous disease in the coronary arteries had higher IMT (p = .034) and lower IM-GSM (p < .001), and those with prior stroke had lower IM-GSM (p = .007). Neither IMT nor IM-GSM was different between patients with and without previous lower extremity vascular disease. IM-GSM was significantly different between groups, it decreased significantly with increasing number of arterial territories affected (37.7 ± 15.4 vs. 29.3 ± 16.4 vs. 20.7 ± 12.9) p < .001, for asymptomatic, symptoms in one and in multiple arterial systems, respectively. Conventional IMT was not significantly different between groups p = .49.
Conclusion:
Carotid IMT was higher and IM-GSM lower in patients with symptomatic nearby arterial territories but not in those with peripheral disease. In contrast to conventional IMT, IM-GSM can differentiate between numbers of arterial territories affected by atherosclerosis, suggesting that it is a better surrogate for monitoring multiple arterial territory disease.
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