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ABSTRACT Background: The earlobe crease (ELC) has been linked to coronary artery disease and other vascular conditions, but there is no information on its association with intracranial atherosclerosis. Objective: This study aimed to assess the association between high calcium content in the carotid siphons (as a surrogate of intracranial atherosclerosis) and ELC in community-dwelling adults living in rural Ecuador. Methods: Atahualpa residents aged ≥40 years underwent head CT to estimate calcium content in the carotid siphons, and visual inspection of both earlobes to evaluate the presence of ELC. The association between both variables was assessed by logistic regression models, after adjusting for demographics and cardiovascular risk factors. Results: Of 651 enrolled individuals (mean age: 59.7±12.8 years; 54% women), 225 (35%) had ELC, and 143 (22%) had high calcium content in the carotid siphons. Univariate logistic regression showed a borderline (non-significant) association between high calcium content in the carotid siphons and ELC presence (OR: 1.44; 95% C.I.: 0.99 - 2.12; p=0.057), which disappeared when age (OR: 0.98; 95% C.I.: 0.65 - 1.48; p=0.923) and other covariables (OR: 0.97; 95% C.I.: 0.63 - 1.49; p=0.890) were added to the model. Conclusion: This population study shows no association between high calcium content in the carotid siphons and ELC presence.
RESUMEN Antecedentes: El pliegue auricular se ha relacionado con enfermedad coronaria y otras patologías vasculares, pero no hay información sobre su asociación con aterosclerosis intracraneal. Objetivo: Este estudio tuvo como objetivo evaluar la asociación entre el contenido de calcio en los sifones carotideos (como un sustituto de aterosclerosis intracraneal) y el pliegue auricular en adultos viven en zonas rurales de Ecuador. Métodos: Los residentes de Atahualpa de 40 años o más fueron sometidos a TC de cerebro para estimar el contenido de calcio en los sifones carotideos. Además, ambas orejas fueron examinadas para detectar la presencia de pliegues auriculares. La asociación entre ambas variables se evaluó mediante modelos de regresión logística, ajustados por factores demográficos y de riesgo cardiovascular. Resultados: De 651 individuos enrolados (edad media: 59,7±12,8 años, 54% mujeres), 225 (35%) tuvieron pliegues auriculares y 143 (22%) tuvieron alto contenido de calcio en los sifones carotideos. La regresión logística univariada mostró una asociación limítrofe (no significativa) entre el contenido de calcio en los sifones carotideos y la presencia de pliegue auricular (OR: 1.44, 95%IC: 0.99 - 2.12, p=0.057), que desapareció cuando la edad (OR: 0.98; 95% I.C.: 0,65 - 1,48; p=0,923) y otras covariables (OR: 0,97; 95% I.C.: 0,63 - 1,49; p=0,890) fueron agregadas al modelo estadístico. Conclusión: El presente estudio no mostró asociación entre el contenido de calcio en los sifones carotídeos y la presencia de pliegue auricular.
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Background: In coronary artery disease (CAD), the DELC (diagonal ear lobe crease) has been proposed as a marker but association remains controversial. The aim of the present study was to evaluate the frequency of DELC in patients with CAD. Materials and Methods: One hundred fifty four patients with coronary artery angiography proven CAD from RIMS, Ranchi, Jharkhand, India were evaluated for the presence or absence of DELC. The DELC was said to be present if the patient had crease extending diagonally from the tragus across the lobule to the rear edge of the without discontinuity. Observation: DELC was seen in 82 patients out of 154, and the prevalence was 53.24%. Prevalence of Hypertension, diabetes and dyslipidemia were 38.3% ,33.8% and 24.0% respectively and hypertension, diabetes and dyslipidemia were insignificant(P=0.245, P=0.526, P=0.203 respectively).There were 43 smoker (27.9%) and DELC with smoking was significant with p value(0.021). Conclusion: The frequency of DELC in patients with CAD was high in our study. The data suggest that the DELC sign may be a useful marker for the presence of CAD in patients and may help in early segregating at risk patient of CAD
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@#Association between diagonal earlobe crease (DELC), also known as Frank’s sign and CAD was first found by Sanders T. Frank in 1973. Since its first description, others have shown it to be associated with the presence, as well as the extent and severity of CAD, independent of traditional CAD risk factors, such as serum lipids, diabetes mellitus, and smoking status.DELC is also associated with higher risk of major adverse cardiac events in patients with known CAD.Recent studies have suggested that DELC may also be a marker of generalized atherosclerotic disease. This study evaluates the association between the presence of diagonal earlobe creases (DELC) and coronary artery disease (CAD). Four hundred people (246 men and 154 women, aged 28 to 92 years) were examined for the presence of DELC.400 people participated. In case group 200 people(142 men and 58 women, aged 30-87) who were getting treatment at State’s central 3rd hospital participated. In control group 200 people(104 men and 96 women, aged 28-92 who were getting treatment at State’s central 3rd hospital, National Traumatology Center included.We did statistic processing with MS Excel 2013, SPSS 20.0 DELC was present in 164 patients (82%) and absent in 36 patients (18%) of 200 participants documented with CAD (presence of > or = 50% coronary diameter stenosis at angiography). DELC was present in 42 people (21%) and absent in 158 people (79%) of 200 people documented without CAD. 82% of individuals with CAD had DELC. There was significant association between diagonal earlobe crease (DELC) and coronary artery disease (CAD), (p=0.039).
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Frank’s sign, also known as diagonal earlobe crease (DELC), was observed to be an aural sign of coronary artery disease (CAD). Since then, there has been much interest in examining this unique and controversial association. This report describes a patient who has bilateral complete and deep diagonal ear lobe creases, presented with angina and diagnosed to have coronary artery disease on angiography. The characteristics of the sign and its association with atherosclerotic disease were discussed.
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La presencia de pliegue diagonal auricular debe alertar al médico para entender su asociación con la enfermedad cardíaca coronaria y la enfermedad isquémica del corazón, especialmente en aquellos pacientes asintomáticos o pacientes con factores de riesgo tradicionales y no tradicionales. Por lo tanto, esta anormalidad puede ser interpretada como un "marcador cutáneo" de la enfermedad cardíaca coronaria. Este signo también podría servir para identificar mejor a los grupos de alto riesgo cardiovascular y para comenzar con la implementación de las medidas de las estrategias de prevención. Hay otros signos clínicos, además del pliegue de la oreja, que pueden reflejar el envejecimiento arterial y aterosclerosis, independientemente del número, duración o alcance de los factores de riesgo cardiovascular tradicionales. El hallazgo de pliegue auricular no debe sustituir a una historia clínica completa, la aplicación de métodos detallados, exámenes de laboratorio y físicos utilizados con excelente rendimiento en el diagnóstico de la enfermedad coronaria en la actualidad.
A diagonal earlobe crease (ELC) should alert doctors to its association with coronary artery disease (CAD) (also known as ischemic heart disease or atherosclerotic heart disease), especially in asymptomatic patients or patients having non-traditional and traditional risk factors. Such abnormality may be interpreted as a skin marker for CAD and this sign may also be used for identifying groups at high cardiovascular risk and indicate when to begin prevention strategy measures. Other clinical signs (apart from ELC) may reflect arterial aging and atherosclerosis, regardless of traditional cardiovascular risk factors' number, duration and/or scope. A finding of ELC should not replace a full medical history being compiled, complemented by the excellent detailed methods and physical and laboratory tests used today for providing a reliable diagnosis regarding coronary disease.
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OBJECTIVES: Several studies found a significant association between earlobe crease (ELC) and cardiovascular disease (CVD). Metabolic syndrome (MS) is a group of high-risk factors that are a collection of cardiovascular risk factors. Scant data are available about the relationship between ELC and MS. The purpose of the current study was to examine the correlation between ELC and MS. METHODS: A cross-sectional study was performed on 3,835 subjects (1,672 females, 43.6%) aged 20 to 79 years who visited a health promotion center. To increase the reliability of the diagnosis of MS, both the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) criteria were applied. Independent association between ELC and MS was assessed using multiple logistic regression analysis after adjusting for confounding variables. RESULTS: The frequency of ELC was 20.89% and the prevalence of MS was 11.03% (NCEP criteria) and 9.75% (IDF criteria). The prevalence of both ELC and MS significantly increased with age. The modified Framingham risk score was significantly higher in subjects with ELC than without. After adjusting for conventional risk factors for CVD, the risk of MS increased significantly in the presence of ELC. CONCLUSION: The current study showed that the odds ratio for MS increased in the presence of ELC in Korean adults. ELC is an auxiliary indicator of MS, although prognostic value might be limited. Further studies are warranted to elucidate the clinical significance of ELC.
Subject(s)
Adult , Aged , Female , Humans , Adenosine Triphosphate , Cardiovascular Diseases , Cholesterol , Cross-Sectional Studies , Health Promotion , Logistic Models , Odds Ratio , Prevalence , Risk FactorsABSTRACT
OBJECTIVES: Several studies have found a significant association between the presence of earlobe crease (ELC) and cardiovascular disease (CVD). Brachial-ankle Pulse Wave Velocity (baPWV) is a non-invasive and useful measure of arterial stiffness predicting cardiovascular events and mortality. However, few studies have reported the relationship between ELC and baPWV as a new measure of arterial stiffness. The purpose of this study was to determine whether ELC is related to baPWV in non-diabetic, non-hypertensive, and apparently healthy Korean adults. METHODS: A cross-sectional study was conducted on 573 non-hypertensive, non-diabetic Korean adults aged 20-80 yr. Subjects were stratified into three groups according to gender and menopausal status. baPWV was measured by an automatic waveform analyser. The association between ELC and baPWV was assessed by multiple linear regression analysis after adjusting for conventional cardiovascular disease risk factors including age, gender, blood pressure, lipid profile, and smoking status etc. RESULTS: The overall frequency of ELC was 19.02% and the subjects with ELC showed significantly higher mean baPWV (p<0.0001). Multiple linear regression of subjects revealed that the presence of ELC was independently associated with baPWV (male, p<0.0001; premenopausal female p=0.0162; postmenopausal female p=0.0208). CONCLUSION: ELC had a significant correlation with baPWV, independently controlling for other classical cardiovascular risk factors in adults aged 20 yr or older. ELC is an important surrogate marker of increased arterial stiffness as measured by baPWV in Korean adults.
Subject(s)
Adult , Aged , Female , Humans , Blood Pressure , Cardiovascular Diseases , Cross-Sectional Studies , Korea , Linear Models , Pulse Wave Analysis , Risk Factors , Smoke , Smoking , Vascular Stiffness , BiomarkersABSTRACT
El surco diagonal es un signo encontrado en el lóbulo de la oreja, que estaría relacionado con la enfermedad arterial coronaria. Nuestro objetivo fue estudiar la utilidad del signo. Se examinaron 104 pacientes (entre 30 y 80 años) clasificados por sexo y edad. Cuarenta y nueve tenían enfermedad arterial coronaria diagnosticada por coronariografía (obstrucción > del 70% en una de las grandes arterias) y/o gamagrafía de perfusión miocárdica con Talio 201 (defecto fijo). El grupo control estuvo compuesto por 55 pacientes (asintomáticos, con electrocardiograma normal). Los datos obtenidos fueron sensibilidad (61.2%), especificidad (78.2%), valor predictivo positivo de (71.4%) y valor predictivo negativo (69.3%.). Observamos una relación significativa entre la presencia de surco diagonal y enfermedad arterial coronaria. Consideramos que este signo podría resultar de utilidad en la práctica clínica, fundamentalmente para los pacientes entre 30 y 60 años.
The diagonal earlobe crease is a sign theorically related to coronary artery disease. The purpose of this study was to prove the usefulness of this sign. A total of 104 patients were examined (ages 30 to 80) grouped by age and sex. Forty nine of them were diagnosed of having coronary artery disease by coronary angiography (a 70% obstruction of one of the major arteries), and/or myocardial perfusion imaging with Thallium 201 (fixed defects). The control group included 55 patients (asymptomatic with normal electrocardiogram). Data here obtained included sensitivity (61.2%), specificity (78.2%), positive predictive value (71.4%) and negative predictive value (69.3%). We found a significant relation between the presence of the diagonal earlobe crease and coronary artery disease. We consider it a sign that could prove useful in clinical practice, mainly among patients aged between 30 and 60.