usefulness of carotid and femoral artery intimal-medial thickness as non-invasive predictors of coronary artery disease

Background: B-mode ultrasonography has shown that measurements of the intima-media thickness of carotid artery [CIMT] is useful in studying atherosclerosis, while study of femoral artery has received little attension

Objective: studying the predictive value of carotid intimal-medial thickness [CIMT] and femoral artery intimal medical thickness [FIMT] for coronary artery disease [CAD] and the relation to risk factors

Methods: Measurement of CIMT and FIMT was performed, utilizing B-mode ultrasonography, for 120 patients [84 males and 36 females] refered for coronary angiography. Biochemical studies included: lipid profile, microalbuminurea, fasting and postprandial blood sugar. Patients were classified into two groups: group l [18 patients] with normal coronary angiography [c. angio] and group 11[102 patients] with abnormal c. angio

Results: CIMT and FIMT were significantly increased in patients with CAD compared to those with normal angiography [P<0.01]. The CIMT and FIMT showed a significant correlation with the extent of CAD [P<0.03 and <0.01], the sensitivity, specificity, positive [ppv] and negative [npv] predictive values of CIMT for CAD were [73.5%, 60.6%, 92.5% and 30%] respectively. While that of FIMT were [88.2%, 88.8%, 97.8% and 57.5%] respectively. Using the univariante analysis: the following parameters were independent risk for CAD: age, DM, hypertension, dyslipidemia, CIMT and FIMT

Conclusion: The CIMT and FIMT can be considered as independent predictors of the presence and extent of CAD, and these non-invasive tests can be used in evaluation and screening for subclinical CAD in high risk population

Thoracic aortic atherosclerosis: the diagnostic approach and the predictive value for coronary artery disease

This work was planned to study the validity of transesophageal echocadiography [TEE], in diagnosis of aortic atherosclerosis, and its predictive value for coronary artery disease. 160 patients refered for coronary angiography were subjected to thorough clinical examination, biochemical studies [blood sugar and lipid profile], transthoracic echo-Doppler study, coronary angiography and transesophageal echocardiography [TEE] to assess aortic atherosclerosis.The patients were classified into two main groups according to angiographic results. I: included 38 patients with normal angiography. II: included 122 with abnormal angiography.Out of the 38 patients with normal angiography, only 4 [10.5%] showed TEE evidence of thoracic aortic atherosclerosis.Aortic intimal medial thickness [AoIMT] > 3 mm, whereas out of 122 with CAD, the percentage of aortic atherosclerosis was [93.4%] P < 0.0001. The grade of atherosclerotic aortic lesions correlated positively with extent of CAD, where as the AoIMT increase, the number of diseased vessels increased. The results showed that the validity of aortic atherosclerosis in prediction of CAD was: sensitivity [93.4%], specificity [89.5%], positive predictive value [96.6%] and the negative predictive value [80.9%]. The regional wall motion abnormality score and index were significantly increased as the AoIMT increase [P<0.01]. It was concluded that the TEE detection of thoracic aortic atherosclerosis is a very good predictive for CAD, with high positive and negative predictive values. AolMT and atherosclerotic plaques could be considered an independent risk predictor for CAD. So TEE should be planned for screening of aortic atherosclerosis in high risk groups to detect subclinical disease, for patients subjected to CABG and for elderly patients subjected to valve surgery to avoid embolic manifestation

possible mechanisms of elevated blood pressure in experimentally obese rats

The association between overweight and hypertension is well established, however the accurate mechanisms involved in the increase of the bl. pressure in obese persons is not well understood. So, the present study was designed in a trial to clarify the possible mechanisms of hypertension with obesity.Where 48 male, age matched rats were used. They were divided into 2 equal groups. Control group fed usual rat diet and obese group fed experimental diet enriched with glucose and fat for 6 weeks. Every 2 weeks from the start of diet regimen, 8 animals from each group undergone the following; measurement of blood pressure [bl. pr.], electrocardiogram [ECG] recording then glucose, insulin, catecholamines and lipid profile assay. The glucose, insulin, catecholamines levels were increased significantly in obese rats in comparison with that in the control rats. Moreover, the H.R and free fatty acids were increased significantly in obese rats when compared with that of control rats. These may be the causes for the recorded elevation in bl. pr. in obese rats in comparison with the control rats. In conclusion, food restriction and reduction of body weight are important non pharmacological methods in treating hypertension