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Intima-Media Thickness and Plaque Evaluation: Predictive Value of Cardiovascular Events and Contribution to Cardiovascular Risk Evaluation

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Noninvasive Vascular Diagnosis
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Abstract

Atherosclerosis prevention and its progression has become an important goal in medicine. Atherosclerotic disease is a long and silently evolving disease and hardly reversible when clinical events occur. New imaging biomarkers are useful if they can help in the early characterization of a population that is at intermediate risk, in order to detect vascular risk phenotypes and improve their management. Ultrasonography of the carotid arteries is safe, inexpensive, easy to perform, and a reliable and accurate method to detect early changes of increased thickening of the arterial wall and plaque occurrence. Intima-media thickness of the carotid artery (CIMT) and plaque are recognized biomarkers which can improve our knowledge and practice in the field of cardiovascular risk evaluation and prevention.

From 1986 to nowadays, thousands of publications have demonstrated the potential of CIMT and plaque to anticipate the risk of coronary and stroke events and to provide signs of silent cardiovascular risk factors by their significant association to hypertension, cholesterol, diabetes, and smoking.

If some recommendations are now published by American and European societies and standardization of the method is ready for use in clinical practice, we need more data on reference values in different countries to address for clinical use the best accuracy for cardiovascular risk evaluation in individuals. Framingham score may be poor for a large group of patients at intermediate risk and some at low risk. The combination of Framingham score and IMT and/or plaque evaluation may increase the power to prevent myocardial infarction and stroke as demonstrated by recent studies. Moreover, Framingham score only provides the cardiovascular risk at 10 years. This limit makes the comparison between a score and a biomarker more difficult.

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Correspondence to Pierre Jean Touboul PhD .

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Review Questions

Review Questions

  1. 1.

    Intima-media thickness is formed by:

    1. a.

      Two parallel lines consisting of leading edges of two boundaries: lumen-intima interfaces and media-adventitia of the CCA in longitudinal view

    2. b.

      Two parallel lines consisting of leading edges of two boundaries: lumen-intima interfaces and intima-adventitia of the CCA in longitudinal view

    3. c.

      Two parallel lines consisting of leading edges of two boundaries: lumen-intima interfaces and media-adventitia of the CCA in transverse view

    4. d.

      None of the above

  2. 2.

    Intima-media thickness measurement should be performed, preferably:

    1. a.

      On the near wall of the CCA, 5–15 mm below carotid bifurcation

    2. b.

      On the far wall of the CCA, 5–15 mm below carotid bifurcation, regardless of the presence of disease

    3. c.

      On the far wall of the CCA, 5–15 mm below carotid bifurcation in a region free of plaque

    4. d.

      On the far wall of the CCA 5–10 mm from the origin of the CCA

  3. 3.

    Most studies evaluating the predictive value of intima-media thickness and stroke showed:

    1. a.

      Relative risk of stroke was around 1.1 per 1 standard deviation CCA IMT difference.

    2. b.

      Relative risk of stroke was around 1.2 per 1 standard deviation CCA IMT difference.

    3. c.

      Relative risk of stroke was around 1.3 per 1 standard deviation CCA IMT difference.

    4. d.

      Relative risk of stroke was around 1.5 per 1 standard deviation CCA IMT difference.

Answer Key

  1. 1.

    a

  2. 2.

    c

  3. 3.

    c

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Touboul, P.J. (2017). Intima-Media Thickness and Plaque Evaluation: Predictive Value of Cardiovascular Events and Contribution to Cardiovascular Risk Evaluation. In: AbuRahma, A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-319-54760-2_12

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  • DOI: https://doi.org/10.1007/978-3-319-54760-2_12

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