Grosor de íntima-media carotídea en niños sanos por técnica ecográfica computarizada / Arterial intima-media thickness in healthy Chilean children using an ultrasonographic computerized technique

Introduction: Vascular endothelium is a target organ in metabolic syndrome. Ultrasound measurement of intimae-media thickness (IMT) is used in adults to predict cardiovascular risk, but normal values in children are unknown. Objective: To describe arterial intima-media thickness in healthy children, by means of an ultrasonographic technique and a specific software. Subjects and Methods: Seventy-four healthy children, 39 males, ages 5-15 y.o., body mass index (BMI) 10-85 percentile were selected from an upper-middle socioeconomic background. Subjects were grouped by age. Three measurements were carried out to each subject at the middle third of the right common carotid for maximal intima-media thickness using a Phillips iU22 ultrasound system; a 12-5 MHz lineal transducer and QLAB advanced quantification software, which includes a specific program for automated IMT measurements, were used. Weight, stature, BMI, and abdominal circumference were registered. Results: No significant differences in the IMT values according to age or gender were found. Median IMT was 0.41 mm (0.40-0.56 mm); 5 children presented IMT 0.50-0.56 mm (> 75th percentile). The median IMT for those children with abdominal circumference < 50th percentile was the same for those over 50th percentile (0.41 mm). Conclusions: Measurements of carotid intima-media thickness for healthy Chilean children were found to be in the expected range, in relation with adult known values.

Introducción: Uno de los sitios de daño asociado a síndrome metabólico es el endotelio vascular; la medición ecográfica del grosor de intima-media carotídea (GIMC) es usado en adultos como un indicador de daño vascular, pero no se conocen valores de normalidad en niños. Objetivo: Estudiar el grosor de intima-media carotídea mediante programa computacional específico, en niños chilenos sanos. Pacientes y Método: Se seleccionaron 72 niños (percentiles 10-85 de IMC sin enfermedad conocida), 5 a 15 años de edad, de estratos socioeconómicos medio-altos, 33 niñas y 39 varones, agrupados por tramos de edad; se les efectuó y promedió 3 mediciones ecográficas en tercio medio de arteria carótida común derecha, mediante equipo Phillips modelo ÍU22; se usó un transductor lineal 12-5 MHz y un software de cuantificación avanzada QLAB, con programa específico de medición automática para grosor de GlMC Además se les midió: peso, talla, 1MC, perímetro abdominal (PA). Se solicitó previamente el consentimiento escrito a padres y niños. Resultados: No hubo diferencias en las mediciones de GlMC de acuerdo a edad o sexo, la mediana fue de 0,41 mm (0,40-0,56 mm); hubo 5 niños entre 0,50 y 0,56 mm (> percentil 75); no hubo correlación con PA o 1MC; los niños con PA < percentil 50 tuvieron una mediana de GlMC igual a aquellos con PA > percentil 50 (0,41 mm). Conclusiones: Las mediciones de grosor de intima-media carotídea de niños y adolescentes chilenos sanos mediante técnica ecográfica y programa computarizado, están dentro de valores esperados para la edad, comparados con valores conocidos de adultos.

Histomorphometric and sympathetic innervation of the human internal thoracic artery

INTRODUCTION: Internal thoracic artery (ITA) is an established arterial graft for the coronary artery by-pass surgery. Special micro-anatomical features of the ITA wall may protect it from age related pathological changes. One of the complications seen after coronary artery bypass grafting is vasospasm. Sympathetic nerves may be involved in vasospasm. OBJECTIVE: To ascertain the sympathetic innervation of the internal thoracic artery and to assess the effect of aging on this artery by histomorphometry. METHOD: Fifty-four human internal thoracic artery samples were collected from 27 cadavers (19 male and 8 female) with ages of 19 to 83 years. Samples were divided into three age groups: G1, 19-40 years; G2, 41-60 years; G3, >61 years. Sections (thickness 5 mm) of each sample were taken and stained with hematoxylin-eosin and Verhoeff-Van Gieson stains. Five of fifty-four samples were processed for tyrosine hydroxylase immunostaining. RESULTS: The thickness of the tunica intima was found to be constant in all age groups, whereas the thickness of the tunica media decreased in proportion to age. Verhoeff-Van Gieson staining showed numerous elastic laminae in the tunica media. Significant differences (p<0.0001) in the number of elastic laminae were found between G1 with G2 cadavers, between G2 and G3 cadavers and between G3 and G1 cadavers. Tyrosine hydroxylase immunostaining demonstrated sympathetic fibers, located mainly in the tunica adventitia and the adventitia-media border. The sympathetic nerve fiber area and sympathetic index were found to be 0.0016 mm² and 0.012, respectively. DISCUSSION: Histology of the ITA showed features of the elastic artery. This may be associated with lower incidence of Atherosclerosis or intimal hyperplasia in ITA samples even in elderly cases. Low sympathetic index (0.012) of ITA may be associated with fewer incidences of sympathetic nervous systems problems (vasospasm) of the ITA. CONCLUSION: Sympathetic ...

[Comparison between carotid IMT of obese adolescents with normal group]

Childhood overweight and obesity can be an underlying cause of atherosclerosis. An early stage of atherosclerosis is shown by intimal thickening. The purpose of this study is to evaluate intima-media thickness [IMT] of carotid arteries on 12 to18 years' old obese children in comparison to control group. In a case-control study, height, weight, blood pressure, cholesterol, triglyceride, mean IMT of body and bulb of carotid artery [of both sides] were measured in eighty [40 obese and 40 normal], 12 to18 years old students. Data was analyzed by X[2] and student - test in SPSS-15 analytical software at P<0.05. The mean age in obese and control groups were 13.9 +/- 1.7 and 14.4 +/- 1.9 years respectively [P=0.192] .The mean weight, cholesterol and triglyceride in the obese group was 72.05 kg, 175.9 mg/dl and 154.9mg/dl. In control group, 47.9 kg, 146.9 mg/dl and 90.05 mg/dl respectively [P<0.000]. The mean carotid artery IMT in obese and control groups were 0.4806, 0.4167 [P<0.00] and the mean IMT of bulb were 0.4885, 0.4362 [P<0.00] respectively. Increase in IMT of body and bulb of carotid artery, were shown in obese adolescences and these increases of thickness were associated with high blood levels of cholesterol and triglyceride

Assessment of carotid artery dimensions by ultrasound in non-smoker healthy adults of both sexes.

Assessment of carotid artery lumen diameter and intima-media thickness is becoming as a surrogate marker of early evaluation of cardiovascular disease. Present study aims to describe the normal carotid dimensions in healthy adults of both sexes. A total of 123 healthy volunteers including 65 men and 58 women, aged 21 to 60 years (mean +/- SD; 35.66 +/- 8.84 years) were studied. Ultrasound study of both carotid arteries were performed with a 7.5 MHz linear array transducer. Common carotid artery lumen diameter ranged from 4.3 mm to 7.7 mm. Difference was not noted between left and right common carotid artery lumen diameter (5.78 +/- 0.57 mm and 5.86 +/- 0.66 mm), and internal and external carotid artery lumen diameter as well. Both left and right common carotid artery, internal and external carotid artery lumen diameter tended to be larger (p < 0.05) in men than women. Common carotid artery intima-media thickness ranged from 0.4 mm to 0.8 mm. Difference was not noted between left and right common carotid intima-media thickness when separately analyzed among men, women and the entire population. Difference was also not noted in comparison between men and women. Conclusion: Common carotid artery and internal and external carotid artery lumen diameter tends to be larger in men than women among young adults. There is no difference between left and right carotid artery lumen diameter. Common carotid artery intima-media thickness is similar in comparison between left and right and both sexes.

Study of the composition of the diagonal artery wall in pig's heart

Se realizó este trabajo con el objetivo de estudiar al microscopio la luz de la arteria diagonal en los corazones de los suinos para analizar la constitución de la pared arterial y la morfometria de las túnicas. Se utilizaron 12 corazones de suinos, de ellos 6 poseían la arteria diagonal mientras que en otros 6 corazones el referido vaso no estaba presente. De los corazones con arteria diagonal, se obtuvieron 18 bloques de 1 cm² del seguimiento inicial de las arterias, siendo 6 arterias diagonales, 6 de arterias interventriculares anteriores y 6 de arterias circunflejas. De los otros 6 corazones sin arteria diagonal fueron retirados 12 bloques de cm², 6 del seguimiento inicial de las arterias interventriculares anteriores y 6 del seguimiento inicial de las arterias circunflejas. Estas piezas fueron sometidas a rutinas histológicas obteniéndose cortes transversales y lomgitudinales de 20um de grosor. Las láminas obtenidas fueron teñidas por los métodos de Weigert- Van Gieson, Verhoef y Azan. La arteria diagonal del corazón del suino puede ser clasificada como una arteria muscular; siendo posible diferenciar las tres túnicas. De ésta, la túnica media es la más diferenciada; mostrando mayor grosor la pared de la arteria interventricular anterior, seguida de la arteria circunfleja y, finalmente, de la diagonal: en todas las arterias (IVA, circunfleja y diagonal) se observó que la pared miocárdica era la más fina, comparada con la epicárdica. Se concluye que la longitud del vaso influye en el grosor de la pared. Cuando mayor es la extensión del vaso, mayor el grosor inicial de la pared y que la presencia de la arteria diagonal determina un menor grosor de la pared de las arterias IVA y circunfleja, comparada a los corazones que no presentan arteria diagonal

Intima-media thickness evaluation by B-mode ultrasound: Correlation with blood pressure levels and cardiac structures

The aim of this study was to analyze the thickness of the intima-media complex (IMC) using a noninvasive method. The carotid and femoral common arteries were evaluated by noninvasive B-mode ultrasound in 63 normotensive and in 52 hypertensive subjects and the thickness of the IMC was tested for correlation with blood pressure, cardiac structures and several clinical and biological parameters. The IMC was thicker in hypertensive than in normotensive subjects (0.67 ± 0.13 and 0.62 ± 0.16 vs 0.54 ± 0.09 and 0.52 ± 0.11 mm, respectively, P<0.0001). In normotensive patients, the simple linear regression showed significant correlations between IMC and age, body mass index and 24-h systolic blood pressure for both the carotid and femoral arteries. In hypertensives the carotid IMC was correlated with age and 24-h systolic blood pressure while femoral IMC was correlated only with 24-h diastolic blood pressure. Forward stepwise regression showed that age, body mass index and 24-h systolic blood pressure influenced the carotid IMC relationship (r2 = 0.39) in normotensives. On the other hand, the femoral IMC relationship was influenced by 24-h systolic blood pressure and age (r2 = 0.40). In hypertensives, age and 24-h systolic blood pressure were the most important determinants of carotid IMC (r2 = 0.37), while femoral IMC was influenced only by 24-h diastolic blood pressure (r2 = 0.10). There was an association between carotid IMC and echocardiographic findings in normotensives, while in hypertensives only the left posterior wall and interventricular septum were associated with femoral IMC. We conclude that age and blood pressure influence the intima-media thickness, while echocardiographic changes are associated with the IMC