CAROTID-ARTERY INTIMA-MEDIA THICKNESS AS AN INDICATOR OF GENERALIZED ATHEROSCLEROSIS
CAROTID-ARTERY INTIMA-MEDIA THICKNESS AS AN INDICATOR OF GENERALIZED ATHEROSCLEROSIS
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DOI：
10.1111/j.1365-2796.1994.tb00847.x
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发表时间：
1994-11-01
影响因子：
11.1
通讯作者：
BOTS, ML
中科院分区：
文献类型：
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作者：
GROBBEE, DE;BOTS, ML
近年来，利用超声图像测量血管壁异常的可能性受到越来越多的关注。特别是，B型超声测量主要动脉壁的厚度已被证明是可行的。颈动脉的B型成像目前被用于几项基于人群的流行病学研究[14]。此外，这项技术被提倡并用于评估某些干预措施逆转动脉粥样硬化的效果[5，61]。这种方法不仅是非侵入性的，血管壁而不是管腔的成像可以评估尚未阻塞管腔的动脉壁的早期疾病或晚期疾病[7]。使用这种方法在有和没有症状性心血管疾病的大组受试者中非侵入性评估动脉粥样硬化的存在和进展，开辟了揭示促进动脉粥样硬化性血管疾病和导致缺血性并发症的因素的方法[8]。然而，超声波测量壁厚的潜力取决于某些假设，其中一些已经在研究中得到测试，另一些仍然是推测的。一种假设是，该技术足够精确和可重复性。第二个假设是，这些图像提供了对感兴趣的紊乱的有效评估，例如动脉粥样硬化。最后，室壁厚度的增加应该与随后的心血管发病率和死亡率相关，以使该测量在纵向研究中作为疾病的中间或替代终点有用。本文讨论了使用超声测量的主要动脉，特别是颈动脉的内膜-中层厚度来可视化和监测动脉粥样硬化的数据。为了说明这些问题，我们借鉴了鹿特丹研究的经验[4]。特别是，问题是颈总动脉内膜-中层厚度直接测量局部动脉粥样硬化是否重要，或者可能仅仅(但有用地)作为全身动脉粥样硬化的定量指标。
In recent years, the possibility of measuring vessel wall abnormalities using ultrasound images has gained increasing interest. In particular, ultrasonographic B-mode measurement of the thickness of the wall of major arteries has shown to be feasible. B-mode imaging of the carotid artery is currently used in several population-based epidemiological studies [14]. In addition, this technique is advocated and used in trials to assess the efficacy of certain interventions to regress atherosclerosis [5, 61. Not only is the method noninvasive, imaging of the vessel wall rather than the lumen permits the evaluation of early disease or advanced disease of the arterial wall that does not yet obstruct the lumen [7]. The use of this approach to assess the presence and progression of atherosclerosis noninvasively in large groups of subjects, with and without symptomatic cardiovascular disease, has opened up ways in which to shed light on the factors that promote atherosclerotic vessel disease and lead to ischaemic complications [8]. However, the potential of ultrasound measurements of wall thickness relies on certain assumptions, some of which have been tested in studies and others that remain speculative. One assumption is that the technique is sufficiently precise and reproducible. A second assumption is that the images provide valid assessments of the disorder of interest, eg atherosclerosis. Finally, increases in wall thickness should be related to subsequent cardiovascular morbidity and mortality to make the measurement useful in longitudinal studies as an intermediate or ‘surrogate’end-point for disease. This paper discusses the data supporting the use of ultrasonographically measured intima-media thickness of the major arteries, and in particular of the carotid artery, for visualizing and monitoring atherosclerosis. To illustrate these issues, experience is drawn from the Rotterdam Study [4]. In particular, the question is addressed of whether it is important that common carotid intima-media thickness directly measures local atherosclerosis or may merely (but usefully) function as a quantitative indicator of generalized atherosclerosis.