Changes in carotid intima-media thickness during the cardiac cycle: the multi-ethnic study of atherosclerosis.
Changes in carotid intima-media thickness during the cardiac cycle: the multi-ethnic study of atherosclerosis.
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DOI：
10.1161/jaha.112.001420
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发表时间：
2012-08
影响因子：
5.4
通讯作者：
Yanez ND
中科院分区：
文献类型：
--
作者：
Polak JF;Johnson C;Harrington A;Wong Q;O'Leary DH;Burke G;Yanez ND
颈总动脉内膜中层厚度（IMT）是亚临床心血管疾病的指标，在心动周期中发生变化。这种影响的程度及其影响尚未得到很好的研究。对来自多种族动脉粥样硬化研究（梅萨）的5633名个体在舒张末期和收缩期峰值测量右颈总动脉远壁IMT。以舒张末期IMT、收缩期峰值IMT和心动周期内IMT变化为因变量，以传统心血管危险因素为自变量，建立多变量回归模型。我国人口的平均年龄为61.9岁（45至84岁）。心动周期内颈动脉IMT的平均变化为0.041 mm（95%置信区间：0.039 ~ 0.042 mm），平均IMT为0.68 mm。舒张末期IMT和收缩期峰值IMT与危险因素相关性相似。在完全校正的模型中，心动周期中颈动脉IMT的变化与种族和脉压相关（P=0.001），而与年龄、性别或其他危险因素无关。与非西班牙裔白人相比，中国人和西班牙裔人的IMT变化较小。以收缩期峰值IMT参考值作为标准数据，31.3%以上的个体被归类为IMT的上四分位数和心血管疾病的高风险，而不是当IMT在结束时测量时的预期。在心动周期中可以观察到IMT的可测量差异。这影响了用于心血管风险评估的IMT测量结果的解释，给出了已发表的收缩期峰值时测量IMT的规范性数据。URL：www.ClinicalTrials. gov。唯一标识符：NCT 00063440。（J Am Heart Assoc.2012;1：e001420 doi：10.1161/JAHA.112.001420.）
Common carotid artery intima-media thickness (IMT), a measure of subclinical cardiovascular disease, changes during the cardiac cycle. The magnitude of this effect and its implications have not been well studied. Far-wall IMT measurements of the right common carotid artery were measured at end diastole and peak systole in 5633 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA). Multivariable regression models were generated with end-diastolic IMT, peak-systolic IMT, and change in IMT during the cardiac cycle as dependent variables and traditional cardiovascular risk factors as independent variables. The average age of our population was 61.9 (45 to 84) years. Average change in carotid IMT during the cardiac cycle was 0.041 mm (95% confidence interval: 0.039 to 0.042 mm), with a mean IMT of 0.68 mm. End-diastolic IMT and peak-systolic IMT were similarly associated with risk factors. In a fully adjusted model, change in carotid IMT during the cardiac cycle was associated with ethnicity and pulse pressure (P=0.001) and not age, sex, or other risk factors. Chinese and Hispanics had less of a change in IMT than did non-Hispanic whites. With peak-systolic IMT reference values used as normative data, 31.3% more individuals were classified as being in the upper quartile of IMT and at high risk for cardiovascular disease than would be expected when IMT is measured at end diastole. Measurable differences in IMT are seen during the cardiac cycle. This affects the interpretation of IMT measurements used for cardiovascular risk assessment, given published normative data with IMT measured at peak systole. URL: www.ClinicalTrials.gov. Unique identifier: NCT00063440. (J Am Heart Assoc. 2012;1:e001420 doi: 10.1161/JAHA.112.001420.)