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Evaluation of common carotid artery changes in Saudi current smokers using medical ultrasound (B-mode and Doppler)

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Abstract

Purpose

This study evaluates using ultrasound the changes that occur in wall thickness, blood flow velocity, and Doppler indices of the common carotid arteries (CCAs) in healthy Saudi adult males who are current smokers.

Methods

A prospective study was performed between May 2011 and May 2013 with a group consisting of nonsmokers (n = 180; 36 %) and current smokers (n = 320; 64 %) with a mean age of 25 ± 2.6 years. In all cases, the CCA ultrasound scanning protocol met the standards established by the American Institute of Ultrasound in Medicine (AIUM) to measure intima media thickness (IMT), peak systolic velocity (PSV), and end diastolic velocity (EDV). The Statistical Package for the Social Sciences (SPSS) was used to analyze the results.

Results

Significant linear and positive correlations were noted between the level of daily consumption of cigarettes smoked and carotid mean IMT, PSV, and Doppler indices, while a linear and negative correlation was present between cigarette smoking and mean EDV. These findings were significant when compared with the results for nonsmokers.

Conclusions

Cigarette smoking is associated with CCA morphological changes caused by significant impairment of arterial endothelial function, and an increase in daily cigarette consumption significantly leads to a decrease in the blood flow velocity of CCAs.

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References

  1. Peto R, Lopez AD. Future worldwide health effects of current smoking patterns. In: Koop CD, Pearson C, Schwarz MR, editors. Critical issues in global health. New York: Jossey-Bass; 2001. p. 154–62.

    Google Scholar 

  2. Marshall L, Schooley M, Ryan H, et al. Youth tobacco surveillance—United States, 2001–2002. MMWR Surveill Summ. 2006;55:1–56.

    PubMed  Google Scholar 

  3. Saudi Arabian Central Department of Statistics. Foreign trade statistics in Saudi Arabia, 1985–1995. Riyadh: Ministry of Finance and National Economy; 1996. p. 15.

    Google Scholar 

  4. Campo-Arias A. The prevalence of nicotine dependency in some populations: a systematic review. Rev Salud Publ (Bogota). 2006;8:98–107.

    Article  Google Scholar 

  5. Bassiony MM. Smoking in Saudi Arabia. Saudi Med J. 2009;30:876–81.

    PubMed  Google Scholar 

  6. Stein JH, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echcardiogr. 2008;21:93–111.

    Article  Google Scholar 

  7. Simon A, Gariepy J, Chironi G, et al. Intima-media thickness: a new tool for diagnosis and treatment of cardiovascular risk. J Hypertens. 2002;20:159–69.

    Article  CAS  PubMed  Google Scholar 

  8. O’Leary DH, Polak JF. Intima-media thickness: a tool for atherosclerosis imaging and event prediction. Am J Cardiol. 2002;90:18L–21L.

    Article  PubMed  Google Scholar 

  9. Gepner AD, Keevil JG, Wymann RA, et al. Use of carotid intima-media thickness and vascular age to modify cardiovascular risk prediction. J Am Soc Echocardiogr. 2006;19:1170–4.

    Article  PubMed  Google Scholar 

  10. Fukuhara T, Namba Y, Kuyama H. Evaluation of extracranial carotid artery duplex ultrasound scanning parameters in cerebral ischemic or nonischemic patients without significant cervical carotid artery stenosis. J Stroke Cerebrovasc Dis. 2005;14:12–6.

    Article  PubMed  Google Scholar 

  11. Bai CH, Chen JR, Chiu HC, et al. Lower blood flow velocity, higher resistance index, and larger diameter of extracranial carotid arteries are associated with ischemic stroke independently of carotid atherosclerosis and cardiovascular risk factors. J Clin Ultrasound. 2007;35:322–30.

    Article  PubMed  Google Scholar 

  12. Fukuhara T, Hida K. Pulsatility index at the cervical internal carotid artery as parameter of microangiopathy in patients with type 2 diabetes. J Ultrasound Med. 2006;2:599–605.

    Google Scholar 

  13. Lee KO, Lee KY, Lee SY, et al. Lacunar infarction in type 2 diabetes is associated with an elevated intracranial arterial pulsatility index. Yonsei Med J. 2007;48:802–6.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Staub D, Meyerhans A, Bundi B, et al. Prediction of cardiovascular morbidity and mortality: comparison of the internal carotid artery resistive index with the common carotid artery intima-media thickness. Stroke. 2006;37:800–5.

    Article  PubMed  Google Scholar 

  15. Vicenzini E, Ricciardi MC, Puccinelli F, et al. Common carotid artery intima-media thickness determinants in a population study. J Ultrasound Med. 2007;26:427–32.

    PubMed  Google Scholar 

  16. Jiang Y, Kohara K, Hiwada K. Association between risk factors for atherosclerosis and mechanical forces in carotid artery. Stroke. 2000;31:2319–24.

    Article  CAS  PubMed  Google Scholar 

  17. Stein JH, Fraizer MC, Aeschlimann SE, et al. Vascular age: Integrating carotid intima-media thickness measurements with global coronary risk assessment. Clin Carotid. 2004;27:388–92.

    Google Scholar 

  18. del sol AI, Moons KG, Hollander M, et al. Is carotid intima-media thickness usefull in cardiovascular disease risk assessment? The Rotterdam study. Stroke. 2001;32:1532–8.

    Article  CAS  PubMed  Google Scholar 

  19. Polak JF, Johnson C, Harrington A, et al. Changes in carotid intima-media thickness during the cardiac cycle: the multi-ethnic study of atherosclerosis. J Am Heart Assoc. 2012;1:e001420.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Grau M, Subirana I, Agis D, et al. Carotid intima-media thickness in the Spanish population: reference ranges and association with cardiovascular risk factors. Rev Esp Cardiol. 2012;65:1086–93.

    Article  PubMed  Google Scholar 

  21. Baliga R, Prabhu G. Orthostatic hypotension in healthy elderly: is it a myth? N Am J Med Sci. 2010;2:416–8.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Fan M, Raitakari OT, Kähönen M, et al. The association between cigarette smoking and carotid intima-media thickness is influenced by the -930A/G CYBA gene polymorphism: the Cardiovascular Risk in Young Finns Study. Am J Hypertens. 2009;22:281–7.

    Article  CAS  PubMed  Google Scholar 

  23. Howard G, Wagenknecht LE, Burke GL, et al. Cigarette smoking and progression of atherosclerosis: The Atherosclerosis Risk in Communities (ARIC) Study. JAMA. 1998;279:119–24.

    Article  CAS  PubMed  Google Scholar 

  24. Howard G, Burke GL, Szklo M, et al. Active and passive smoking are associated with increased carotid wall thickness. The Atherosclerosis Risk in Communities Study. Arch Intern Med. 1994;154:1277–82.

    Article  CAS  PubMed  Google Scholar 

  25. Fox CS, Polak JF, Chazaro I, et al. Genetic and environmental contributions to atherosclerosis phenotypes in men and women: heritability of carotid intima-media thickness in the Framingham Heart Study. Stroke. 2003;34:397–401.

    Article  PubMed  Google Scholar 

  26. Barutcu I, Esen AM, Degirmenci B, et al. Acute cigarette smoking-induced hemodynamic alterations in the common carotid artery: a transcranial Doppler study. Circ J. 2004;68:1127–31.

    Article  PubMed  Google Scholar 

  27. Lee VS, Hertzberg BS, Kliewer MA, et al. Assessment of stenosis: implications of variability of Doppler measurements in normal-appearing carotid arteries. Radiology. 1999;212:493–8.

    Article  CAS  PubMed  Google Scholar 

  28. Halpern EJ, Merton DA, Forsberg F. Effect of distal resistance on Doppler US flow patterns. Radiology. 1998;206:761–6.

    Article  CAS  PubMed  Google Scholar 

  29. Bude RO, Rubin JM. Relationship between the resistive index and vascular compliance and resistance. Radiology. 1999;211:411–7.

    Article  CAS  PubMed  Google Scholar 

  30. Boyajian RA, Otis SM. Acute effects of smoking on human cerebral blood flow: a transcranial Doppler ultrasonography study. J Neuroimaging. 2000;10:204–8.

    CAS  PubMed  Google Scholar 

  31. Liang YL, Shiel LM, Teede H, et al. Effects of blood pressure, smoking and their interaction on carotid artery structure and function. Hypertension. 2001;37:6–11.

    Article  CAS  PubMed  Google Scholar 

  32. Fujiwara H. Anti-smoking declaration: a message from the Japanese Circulation Society. Circ J. 2003;67:1–2.

    Article  PubMed  Google Scholar 

  33. Itani Y, Watanabe S, Masuda Y. Aortic calcification detected in a mass chest screening program using a mobile helical computed tomography unit: relationship to risk factors and coronary artery disease. Circ J. 2004;68:538–41.

    Article  PubMed  Google Scholar 

  34. Das Sidhartha, Chakrabarty Kamalesh, Patnaik Madhusmita, et al. The relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) in Asian-Indian patients with acute ischemic stroke with and without type 2 DM. IJCM. 2011;2:561–7.

    Article  Google Scholar 

  35. Barry R, Pienaar A, Pienaar C, et al. Duplex Doppler investigation of suspected vascular lesions at the carotid bifurcation. Ann Vasc Surg. 1993;7:140–4.

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors received a research grant from the Scientific Research Deanship of Salman bin Abdulaziz University (SAU), Al-Kharj, Saudi Arabia.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent for being included in the study was obtained from all patients.

Author information

Authors and Affiliations

  1. Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia

    Khalid S. Alzimami

  2. Radiology and Medical Imaging Department, College of Applied Medical Sciences, Salman bin Abdulaziz University, Al-Kharj, Saudi Arabia

    Mustafa Z. Mahmoud & Abdelmoneim Sulieman

  3. Basic Sciences Department, College of Medical Radiological Sciences, Sudan University of Science and Technology, Khartoum, Sudan

    Mustafa Z. Mahmoud

Authors
  1. Khalid S. Alzimami
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  2. Mustafa Z. Mahmoud
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  3. Abdelmoneim Sulieman
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Corresponding author

Correspondence to Khalid S. Alzimami.

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Alzimami, K.S., Mahmoud, M.Z. & Sulieman, A. Evaluation of common carotid artery changes in Saudi current smokers using medical ultrasound (B-mode and Doppler). J Med Ultrasonics 41, 351–357 (2014). https://doi.org/10.1007/s10396-013-0509-5

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  • DOI: https://doi.org/10.1007/s10396-013-0509-5

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