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- Akhter, Tansim, 1967-, et al.
(författare)
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Individual Common Carotid Artery Wall Layer Dimensions, but Not Carotid Intima-Media Thickness, Indicate Increased Cardiovascular Risk in Women With Preeclampsia : An investigation using non-invasive high-frequency ultrasound
- 2013
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Ingår i: Circulation Cardiovascular Imaging. - 1941-9651 .- 1942-0080. ; 6:5, s. 762-768
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Tidskriftsartikel (refereegranskat)abstract
- Background Preeclampsia (PE) is associated with increased risk of cardiovascular disease later in life. Ultrasound assessment of the common carotid artery intima-media thickness (IMT) during or after PE has not indicated any increased cardiovascular risk. Methods and Results We used high-frequency ultrasound (22 MHz) to estimate the individual common carotid artery IMTs in 55 women at PE diagnosis and in 64 women with normal pregnancies at a similar stage. All were re-examined about 1 year postpartum. A thick intima, thin media, and high intima/media (I/M) ratio are signs of a less healthy artery wall. PE was associated with a significantly thicker mean common carotid artery intima, thinner media, and higher I/M ratio than in normal pregnancy (mean I/M difference, 0.21; 95% confidence interval, 0.17-0.25; P<0.0001). After adjustment for first trimester body mass index and mean arterial pressure, differences in intima thickness and I/M remained significant. About 1 year postpartum, these values had improved in both groups, but group differences remained significant (all adjusted P<0.0001). There were no significant differences in IMT between groups. In receiver-operating characteristic curve analysis, intima thickness and I/M were strongly predictive of prevalent PE (area under the curve, approximate to 0.95), whereas IMT was not (area under the curve, 0.49). Conclusions The arteries of women with PE were negatively affected during pregnancy and 1 year postpartum compared with women with normal pregnancies, indicating increased cardiovascular risk. Estimation of intima thickness and I/M ratio seem preferable to estimation of common carotid artery IMT in imaging cardiovascular risk in PE. Results from this pilot study warrant further confirmation.
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| 2. |
- Bang, Casper N., et al.
(författare)
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Four-Group Classification of Left Ventricular Hypertrophy Based on Ventricular Concentricity and Dilatation Identifies a Low-Risk Subset of Eccentric Hypertrophy in Hypertensive Patients
- 2014
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Ingår i: Circulation Cardiovascular Imaging. - 1941-9651 .- 1942-0080. ; 7:3, s. 422-429
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Tidskriftsartikel (refereegranskat)abstract
- Background-Left ventricular hypertrophy (LVH; high LV mass [LVM]) is traditionally classified as concentric or eccentric based on LV relative wall thickness. We evaluated the prediction of subsequent adverse events in a new 4-group LVH classification based on LV dilatation (high LV end-diastolic volume [EDV] index) and concentricity (mass/end-diastolic volume [M/EDV](2/3)) in hypertensive patients. Methods and Results-In the Losartan Intervention for Endpoint Reduction (LIFE) echocardiography substudy, 939 hypertensive patients with measurable LVM at baseline were randomized to a mean of 4.8 years of losartan- or atenolol-based treatment. Patients with LVH (LVM/body surface area >= 116 and >= 96 g/m(2) in men and woman, respectively) were divided into 4 groups-concentric nondilated (increased M/EDV, normal EDV), eccentric dilated (increased EDV, normal M/EDV), concentric dilated (increased M/EDV and EDV), and eccentric nondilated (normal M/EDV and EDV)-and compared with patients with normal LVM. Time-varying LVH classes were tested for association with all-cause and cardiovascular mortality and a composite end point of myocardial infarction, stroke, heart failure, and cardiovascular death in multivariable Cox analyses. At baseline, the LVs were categorized as eccentric nondilated in 12%, eccentric dilated in 20%, concentric nondilated in 29%, concentric dilated in 14%, and normal LVM in 25%. Treatment changed the prevalence of 4 LVH groups to 23%, 4%, 5%, and 7%; 62% had normal LVM after 4 years. In time-varying Cox analyses, compared with normal LVM, those with eccentric dilated and both concentric nondilated and dilated LVH had increased risks of all-cause or cardiovascular mortality or the composite end point, whereas the eccentric nondilated group did not. Conclusions-Hypertensive patients with relatively mild LVH without either increased LV volume or concentricity have similar risk of all-cause mortality or cardiovascular events because hypertensive patients with normal LVM seem to be a low-risk group.
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| 4. |
- Nchimi, Alain, et al.
(författare)
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Multifactorial Relationship Between F-18-Fluoro-Deoxy-Glucose Positron Emission Tomography Signaling and Biomechanical Properties in Unruptured Aortic Aneurysms
- 2014
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Ingår i: Circulation Cardiovascular Imaging. - 1941-9651 .- 1942-0080. ; 7:1, s. 82-91
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Tidskriftsartikel (refereegranskat)abstract
- Background The relationship between biomechanical properties and biological activities in aortic aneurysms was investigated with finite element simulations and F-18-fluoro-deoxy-glucose (F-18-FDG) positron emission tomography. Methods and Results The study included 53 patients (45 men) with aortic aneurysms, 47 infrarenal (abdominal aortic) and 6 thoracic (thoracic aortic), who had 1 F-18-FDG positron emission tomography/computed tomography. During a 30-month period, more clinical events occurred in patients with increased F-18-FDG uptake on their last examination than in those without (5 of 18 [28%] versus 2 of 35 [6%]; P=0.03). Wall stress and stress/strength index computed by finite element simulations and F-18-FDG uptake were evaluated in a total of 68 examinations. Twenty-five (38%) examinations demonstrated 1 aneurysm wall area of increased F-18-FDG uptake. The mean number of these areas per examination was 1.6 (18 of 11) in thoracic aortic aneurysms versus 0.25 (14 of 57) in abdominal aortic aneurysms, whereas the mean number of increased uptake areas colocalizing with highest wall stress and stress/strength index areas was 0.55 (6 of 11) and 0.02 (1 of 57), respectively. Quantitatively, F-18-FDG positron emission tomographic uptake correlated positively with both wall stress and stress/strength index (P<0.05). F-18-FDG uptake was particularly high in subjects with personal history of angina pectoris and familial aneurysm. Conclusions Increased F-18-FDG positron emission tomographic uptake in aortic aneurysms is strongly related to aneurysm location, wall stress as derived by finite element simulations, and patient risk factors such as acquired and inherited susceptibilities.
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| 5. |
- Steigner, Michael L, et al.
(författare)
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Iodinated Contrast Opacification Gradients in Normal Coronary Arteries Imaged With Prospectively ECG-Gated Single Heart Beat 320-Detector Row Computed Tomography
- 2010
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Ingår i: CIRCULATION-CARDIOVASCULAR IMAGING. - : Lippincott Williams & Wilkins. - 1941-9651 .- 1942-0080. ; 3:2, s. 179-186
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Tidskriftsartikel (refereegranskat)abstract
- Background-To define and evaluate coronary contrast opacification gradients using prospectively ECG-gated single heart beat 320-detector row coronary angiography (CTA). Methods and Results-Thirty-six patients with normal coronary arteries determined by 320 x 0.5-mm detector row coronary CTA were retrospectively evaluated with customized image postprocessing software to measure Hounsfield Units at 1-mm intervals orthogonal to the artery center line. Linear regression determined correlation between mean Hounsfield Units and distance from the coronary ostium (regression slope defined as the distance gradient G(d)), lumen cross-sectional area (G(a)), and lumen short-axis diameter (G(s)). For each gradient, differences between the 3 coronary arteries were analyzed with ANOVA. Linear regression determined correlations between measured gradients, heart rate, body mass index, and cardiac phase. To determine feasibility in lesions, all 3 gradients were evaluated in 22 consecutive patients with left anterior descending artery lesions andgt;= 50% stenosis. For all 3 coronary arteries in all patients, the gradients G(a) and G(s) were significantly different from zero (P andlt; 0.0001), highly linear (Pearson r values, 0.77 to 0.84), and had no significant difference between the left anterior descending, left circumflex, and right coronary arteries (P andgt; 0.503). The distance gradient G(d) demonstrated nonlinearities in a small number of vessels and was significantly smaller in the right coronary artery when compared with the left coronary system (P andlt; 0.001). Gradient variations between cardiac phases, heart rates, body mass index, and readers were low. Gradients in patients with lesions were significantly different (P andlt; 0.021) than in patients considered normal by CTA. Conclusions-Measurement of contrast opacification gradients from temporally uniform coronary CTA demonstrates feasibility and reproducibility in patients with normal coronary arteries. For all patients, the gradients defined with respect to the coronary lumen cross-sectional area and short-axis diameters are highly linear, not significantly influenced by the coronary artery (left anterior descending artery versus left circumflex versus right coronary artery), and have only small variation with respect to patient parameters. Preliminary evaluation of gradients across coronary artery lesions is promising but requires additional study.
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