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This study aimed to investigate the association of vegetable and fruit consumption with carotid plaque (CP) and carotid intima-media thickness (CIMT), two predictors of carotid atherosclerosis, within urban and rural adults at high risk of developing cardiovascular diseases (CVDs) in regional China. A total of 11,392 adults at high CVD risk were identified from general population of 71,511 in this cross-sectional study, conducted between November of 2015 and May of 2016 in the Jiangsu Province. Among these 11,392 high risk participants, CP prevalence was 36.7%. The independent variables, vegetable and fruit intake frequency, were assessed by a food frequency questionnaire. The outcome variables, CIMT and CP, were measured by ultrasound examination. The ANCOVA analysis showed no association between CIMT values and vegetable and fruit intake frequencies. Multivariate logistic regression models were introduced to examine the association between vegetable and fruit intake and CP. After adjustment for potential confounders, the odds ratios (ORs) for participants who occasionally and daily consumed vegetable to experience any CP were 0.67 (95%CI: 0.58-0.78) and 0.70 (95%CI: 0.62-0.79), respectively, compared with those rarely consumed vegetable. While the adjusted ORs were 0.77 (95%CI: 0.64-0.92) and 0.80 (95%CI: 0.68-0.94), separately, for occasional and daily vegetable consumers to develop single CP relative to their counterparts who rarely consumed any vegetables. However, no significant association between fruit consumption and CP was observed. Among the Chinese population at high CVD risk, consumption of fresh vegetables was negatively associated with the risk of developing carotid plaque.
O estudo buscou investigar a associação entre consumo de frutas e verduras e placa carotídea (PC) e espessura íntima-média carotídea (EIMC), dois preditores de aterosclerose entre adultos das áreas urbana e rural com alto risco de desenvolver doenças cardiovasculares (DCVs) em uma região da China. Foram identificados 11.392 adultos com alto risco de DCV, entre 71.511 indivíduos da população geral, em um estudo transversal entre novembro de 2015 e maio de 2016 na Província de Jiangsu. Entre esses 11.392 participantes de alto risco, a prevalência de PC foi de 36,7%. As variáveis independentes, ou seja, frequências de consumo de frutas e verduras, foram avaliadas através de um questionário de frequência alimentar. As variáveis de desfecho, EIMC e PC, foram medidas por ultrassom. A análise ANCOVA não mostrou associação entre valores de EIMC e frequências de consumo de frutas e verduras. Foram introduzidos modelos de regressão logística multivariada para examinar a associação entre consumo de frutas e verduras e PC. Depois de ajustar para potenciais fatores de confusão, as ORs para participantes com consumo eventual e diário de verduras para qualquer PC foram 0,67 (IC95%: 0,58-0,78) e 0,70 (IC95%: 0,62-0,79), respectivamente, comparado com aqueles com consumo raro de verduras. Enquanto isso, as ORs ajustados foram 0,77 (IC95%: 0,64-0,92) e 0,80 (IC95%: 0,68-0,94), separadamente, para adultos com consumo eventual e diário de verduras para desenvolver uma PC única, comparado aos que relatavam consumo raro de verduras. Entretanto, não foi observada uma associação significativa entre consumo de frutas e PC. Entre a população chinesa com alto risco de DCV, o consumo de verduras frescas mostrou associação negativa com o risco de desenvolvimento de placa carotídea.
El objetivo de este estudio fue investigar la asociación del consumo de frutas y verduras con la placa carotídea (PC) y el grosor íntima-media carotídeo (GIMC), dos predictores de la aterosclerosis carotídea en adultos urbanos y rurales, con alto riesgo de desarrollar enfermedades cardiovasculares (ECV) en una región de China. Se identificaron, en este estudio transversal, a 11.392 adultos con alto riesgo de ECV dentro de una población general de 71.511, realizado entre noviembre de 2015 y mayo de 2016 en la provincia de Jiangsu. De estos 11.392 participantes en alto riesgo, la prevalencia de PC fue de un 36,7%. Las variables independientes, así como la frecuencia de consumo de verduras y fruta, se evaluaron mediante un cuestionario de frecuencia de comidas. Las variables de resultado, GIMC y PC, se midieron por un examen de ultrasonido. El análisis ANCOVA mostró que no existía asociación entre los valores GIMC y la frecuencia en el consumo de verduras y frutas. Los modelos de regresión logística multivariantes se introdujeron para examinar la asociación entre el consumo de verduras y frutas y la PC. Tras el ajuste para los factores potenciales de confusión, las ORs de haber tenido alguna PC para los participantes que ocasionalmente y diariamente consumían verduras fueron 0,67 (IC95%: 0,58-0,78) y 0,70 (IC95%: 0,62-0,79), respectivamente, comparadas con quienes raramente consumían verduras. Mientras que las ORs ajustadas fueron 0,77 (IC95%: 0,64-0,92) y 0,80 (IC95%: 0,68-0,94), separadamente, para los consumidores ocasionales y los consumidores diarios de verduras de desarrollar una única PC, en relación con sus contrapartes que raramente consumían verduras. No obstante, no se observó una asociación significativa entre el consumo de frutas y la PC. Entre la población con alto riesgo de ECV, el consumo de verdura fresca estuvo negativamente asociado con el riesgo de desarrollar PC.
Sujets)
Humains , Adulte , Légumes , Artériopathies carotidiennes/étiologie , Artériopathies carotidiennes/épidémiologie , Artériopathies carotidiennes/imagerie diagnostique , Brésil , Chine/épidémiologie , Études transversales , Régime alimentaire , Épaisseur intima-média carotidienne , FruitRésumé
Objective:To investigate the prevalence of carotid artery plaque (CP) in the population undergoing health examinations and to assess the association between CP and Helicobacter pylori (Hp) infection.Methods:The subjects were 3066 patients who underwent carotid ultrasonography examination and 13C urea breath test (UBT) at the health examination center of China-Japan friendship hospital from January 2019 to December 2019. The subjects were divided into CP and non-CP groups; the differences of physicochemical parameters and UBT positive rate between the two groups were analyzed by independent sample t test, Mann-Whitney U test, and Chi-squared test. The association between UBT positive and CP was analyzed by logistic regression. Results:The proportion of CP positive subjects was significantly higher in males than in females (33.4% vs 19.5%, P<0.001); the proportion of Hp positive subjects was not significant in sex composition (29.1% vs 30.9%, P=0.245); the age [(59.39±10.24) vs (46.44±9.88) years], P<0.01), BMI [(25.44±3.23) vs (24.21±3.54) kg/m 2, P<0.01], SBP [(135.91±19.07) vs (123.03±16.66) mmHg, P<0.01], DBP [(79.64±11.47) vs (75.10±11.55) mmHg, P<0.01], TC [(4.96±0.98) vs (4.86±0.98) mmol/L, P=0.004], TG [1.43 (1.03, 2.06) vs 1.20 (0.82,1.88) mmol/L, P<0.001], LDL-c [(3.21±0.93) vs (3.04±0.83) mmol/L, P<0.01)], FBG [5.55 (5.11,6.47) vs 5.16 (4.83,5.56) mmol/L, P<0.001], UA [(339.13±79.92) vs (319.85±87.62) mmol/L, P<0.01] and Hcy [13.10 (11.30,15.60) vs 11.7 (10.00,13.90) mmol/L, P<0.001] were significantly higher in the CP group than that in the non-CP group; HDL-c was significantly lower in the CP group than in the non-CP group [1.12 (0.95,1.32) vs 1.20 (1.00,1.43) mmol/L, P<0.001]. The proportion of male (62.4% vs 44.6%, P<0.01), prevalence of tobacco smoking (31.9% vs 19.6%, P<0.01), hypertension (33.8% vs 12.5%, P<0.01), and diabetes (13.45% vs 3.5%, P<0.01) were significantly higher in the CP group than that in the non-CP group. The proportion of UBT positive subjects was significantly higher in the CP group than in the non-CP group (34.5% vs 28.4%, P=0.001). Logistic regression analysis showed a significantly positive association between CP and UBT positive after adjusted confounding factors ( OR=1.270, P=0.028). Conclusions:The formation of CP is related to many risk factors; Hp infection is also an important risk factor. Controlling Hp infections might be one of the effective methods for the prevention and control of carotid plaque formation.
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Objective We aimed to investigate whether sex hormone levels including total testosterone, estradiol, estradiol/total testosterone, and dehydroepiandrosterone ( DHEA ) were associated with macrovascular complications among Shanghai community-dwelling diabetic men. Methods Relying on the Environmental Pollutant Exposure and Metabolic Diseases in Shanghai (METAL) study (ChiCTR1800017573, www.chictr.org.cn), 2147 male diabetic participants were recruited from 10 communities. Carotid plaques and common carotid artery ( CCA) diameters were detected by carotid ultrasound. Cardiovascular disease ( CVD) was defined as a self-reported diagnosis of CVD, including coronary heart disease, myocardial infarction, or stroke. Results ( 1) The prevalence of CVD in this study was 36. 0％, and patients with CVD had higher rates of hypertension and dyslipidemia than those without CVD. ( 2) After controlling for multiple factors, serum DHEA levels were negatively correlated with the prevalence of CVD while estradiol levels were positively correlated with both the prevalences of CVD and carotid plaque, estradiol/total testosterone ratio was also positively correlated with the prevalence of CVD. ( 3) In subgroup with unilateral/bilateral CCA plaque, and after controlling for multiple factors, total serum testosterone was negatively associated with the mean CCA diameter. Conclusion The incidence of macrovascular complications was lower in male diabetic patients with higher serum total testosterone and DHEA levels and lower estradiol levels, suggesting that sex hormone levels may be a window for the diagnosis and treatment of diabetic macrovascular complications.
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Objective To investigate the value of acoustic radiation force impulse imaging (ARFI) combined with contrast-enhanced ultrasound (CEUS) in diagnosis of acute cerebral ischemia (ACI) in patients with carotid artery vulnerable plaque (VP). Methods One hundred and ten patients with carotid artery VP diagnosed by routine ultrasound admitted to Renhe Hospital Affiliated to Three Gorges University from October 2017 to January 2019 were selected as subjects, including 59 patients with ACI (ACI group) and 51 patients with non-ACI (non-ACI group) confirmed by magnetic resonance imaging (MRI). All patients underwent routine ultrasound, CEUS and ARFI examinations, the differences in sizes of VP, shear wave velocity (SWV) and enhancement intensity (EI) were compared, and the diagnostic values of SWV and EI were evaluated by the analyses of receiver operating characteristic curve (ROC). Results Two hundred and ten VPs were found in 110 patients, including 112 grade 1 plaques, 53 grade 2 plaques, and 45 grade 3 plaques, compared with grade 1 plaques, the proportion of mixed echo (MP) and strong echo (SP) in grade 2 plaques, and the proportion of all echo types in grade 3 plaques were all significantly different from that of grade 1 plaques (all P < 0.05); compared with grade 1 plaques, the proportion of grade 2 plaques with thickness ≤ 2.0 mm, and the proportion of grade 3 plaques with thickness ≤ 2.0 mm and more than 3.1 mm were all significantly different from that of grade 1 plaques (all P < 0.05). SWV in ACI group was obviously lower than that in non-ACI group (m/s: 1.91±0.54 vs. 2.41±0.57), and EI in ACI group was significantly higher than that in non-ACI group (dB: 3.62±1.13 vs. 2.81±1.05), the difference being statistically significant (both P < 0.05). The area under the ROC curve (AUC) of SWV was 0.681 and the cutoff value was 2.21 m/s, sensitivity, specificity, positive predictive value and negative predictive value were 83.05%, 80.39%, 83.05%, 80.39%; the AUC of EI was 0.638, and the cutoff value was 3.71 dB, sensitivity, specificity, positive predictive value and negative predictive value were 79.66%, 74.51%, 78.33%, 76.00%. AUC of SWV combined with EI was 0.812, sensitivity, specificity, positive predictive value and negative predictive value were 93.22%, 94.12%, 94.83%, 92.31%, significantly higher than those of SWV or EI alone (all P < 0.05). Conclusion In ACI patients, the SWV of VP decreases and EI of VP increases, the detection efficacy of SWV combined with EI for diagnosis of ACI has relatively high clinical value, as the combined diagnostic efficiency is significantly higher than that of either SWV or EI alone.
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Objective Carotid atherosclerotic plaque is regarded as an important risk factor for ischemic cerebrovascular disease.This study analyzed the factors influencing the number of carotid atherosclerotic plaques in patients with ischemic stroke.Methods We selected 194 patients with crerbral infarction admitted to the Department of Neurology of Second Hospital Affiliated to Lanzhou University from December 2015 to December 2016.Neck vascular color Doppler ultrasound test was performed,and the number of carotid atherosclerotic plaques in each patient was counted.According to the number,we divided them into three groups:single,double and multiple.The patients'sex,age,hypertension,hyperlipemia,diabetes and history of ischemic stroke were recorded. Multivariate Logistic regression analysis was used to analyze the factors influencing plaques.Results Multivariate Logistic regression analysis showed that gender,hypertension,hyperlipidemia,and history of cerebral infarction were risk factors for single carotid artery plaque;hyperlipidemia and diabetes mellitus were risk factors for double carotid artery plaque;and gender,diabetes,and history of cerebral infarction were risk factors for multiple carotid artery plaque.Conclusion Different numbers of plaques may have common risk factors but different numbers of plaque morphology have their own risk factors.
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Objective To investigate the clinical application of serum miRNA-126,miRNA-155 detection in evaluation of plaque property in the carotid atherosclerotic(CAS)desease.Methods A total of 75 patients with the CAS from May 2015 to May 2017 in the Xianyang Central Hospital and Shiquan Country Chinese Traditional Medicine was chosen,consisted of 35 cases of vulvernable plaque group and 40 cases of stable plaque group.Meanwhile,39 cases of healthy physical examines at the same time were regarded as the control group.The expression levels of serum miRNA-126,miRNA-155 in the groups were detected using the real-time reverse transcription-polymerase chain reaction technique.The largest carotid artery plaque thickness(MAPT)and intima-media thickness(IMT)in the groups were measured using the cervical enhancement CT.Re-sults The results of MAPT and IMT were(3.27±1.01 mm,1.93±0.51 mm)in the vulvernable plaque group and(2.50 ±0.79 mm,1.60±0.26 mm)in the stable plaque group.The carotid artery largest plaque thickness and intima-media thick-ness was higher in the vulvernable plaque group than in the stable plaque group(t=9.76,7.86,P<0.01),and there were significant differenes between the two groups.The expression levels of serum miRNA-126and miRNA-155 were(0.22 ± 0.06,0.87±0.18)in the vulvernable plaque group,(0.50±0.12,0.47±0.10)in the stable plaque group and(0.90±0.19, 0.19±0.05)in the control group.MiRNA-155 expression levels significantly increased in stable plaque group and vulvern-able plaque group compared with in the control group,which increased in the vulvernable plaque group compared with in the stable plaque group,and miRNA-126 expression levels markedly decreased,the differences were statistically significant(F=119.3,102.9,P<0.01).In the vulvernable plaque group,miRNA-126 expression negatively correlated with miRNA-155(r=0.912,P<0.01).miRNA-126 expression levels were inversely associated with the carotid artery largest plaque thickness and the intima-media thickness(r=-0.913,-0.893,P<0.01).While miRNA-155 expression levels were positively corre-lated with them(r=0.899,0.907,P<0.01).Conclusion Serum miRNA-155,miRNA-126 detection can be applied to pre-diction of CAS plaques rupture,and may become a useful warning marker of ischemic stroke events.
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Objective:To study the predictive value of carotid plaque score for evaluating the severity of coronary artery lesions.Methods:A total of 152 patients with coronary angiography diagnosed coronary artery disease (CAD) in our hospital from 2016-01 to 2016-05 were selected.According to coronary branch involvement,the patients were divided into 3 groups:Single branch lesion group,n=72,Double branch lesion group,n=38 and Multi branch lesion group,n=42.The basic conditions as plaque detection rate,high-density lipoprotein cholesterol (HDL-C),body mass index (BMI) were collected and carotid ultrasound examination was conducted in all patients.Carotid plaque condition and coronary lesion degree were calculated by semi-quantitative score and Gensini score methods;the relationship between semi-quantitative score and Gensini score was compared.Results:Total cholesterol (TC),HDL-C,LDL-C and BMI were similar among different groups,P＞0.05.Compared with Single branch lesion group,Double branch lesion group and Multi branch lesion group had more smokers and the higher plaque detection rate,P＜0.05.Semi-quantitative score and Gensini score were elevating as coronary lesion branch increasing accordingly.Conclusion:The severity of coronary lesions could be evaluated and predicted by semi-quantitative calculation of carotid integral.
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Objective:To study the predictive value of carotid plaque score for evaluating the severity of coronary artery lesions.Methods:A total of 152 patients with coronary angiography diagnosed coronary artery disease (CAD) in our hospital from 2016-01 to 2016-05 were selected.According to coronary branch involvement,the patients were divided into 3 groups:Single branch lesion group,n=72,Double branch lesion group,n=38 and Multi branch lesion group,n=42.The basic conditions as plaque detection rate,high-density lipoprotein cholesterol (HDL-C),body mass index (BMI) were collected and carotid ultrasound examination was conducted in all patients.Carotid plaque condition and coronary lesion degree were calculated by semi-quantitative score and Gensini score methods;the relationship between semi-quantitative score and Gensini score was compared.Results:Total cholesterol (TC),HDL-C,LDL-C and BMI were similar among different groups,P＞0.05.Compared with Single branch lesion group,Double branch lesion group and Multi branch lesion group had more smokers and the higher plaque detection rate,P＜0.05.Semi-quantitative score and Gensini score were elevating as coronary lesion branch increasing accordingly.Conclusion:The severity of coronary lesions could be evaluated and predicted by semi-quantitative calculation of carotid integral.
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Objective To study relationship between the level of serum ICAM,ALCAM,VCAM and PECAM-1 in elderly patients with type 2 diabetes mellitus combined with acute cerebral infarction and its meaning.Methods From July 2014 to December 2015,60 patients with type 2 diabetes mellitus complicated with acute cerebral infarction were chosen as the research object.They were divided into three groups according to severity of atherosclerosis:no plaque in 11 cases,22 cases of stable plaques and unstable plaque 27 cases.40 cases with acute cerebral infarction patients and 40 cases of patients with type 2 diabetes were selected as a disease control;and other 40 healthy subjects were selected as healthy controls.ELISA were used to detect ICAM,ALCAM,VCAM and PECAM 1 level.Neural function evaluation was made by the U.S national institutes of health stroke scale (NIHSS).Results The ICAM,ALCAM,VCAM,PECAM 1 level in diabetic cerebral infarction group were higher than the other three groups,the difference was statistically significant (P＜0.05),while those of cerebral infarction group and diabetes group were higher than the control group,the difference was statistically significant (P＜0.05),and those of cerebral infarction group and diabetes group has no statistical significance (P＞0.05).NIHSS score of diabetic cerebral infarction patients was (7.39 ± 1.72),which was higher than that of patients with cerebral infarction group (5.33 ± 1.49),the difference was statistically significant (t=4.376,P =0.019,P＜0.05).The serum ICAM,ALCAM,VCAM,PECAM 1 level of diabetic cerebral infarction patients was a positively correlated with NIHSS score (r=0.559,P=0.007;r=0.619,P=0.000;r=0.421,P=0.018;r=0.451,P=0.007).With diabetic cerebral infarction is aggravating,the severity of carotid plaques in patients with serum ICAM,ALCAM,VCAM,PECAM-1 level is on the rise (P＜0.05).Conclusion ICAM,ALCAM,VCAM,PECAM-1 levels in peripheral blood serum of patients with type 2 diabetes mellitus complicated with acute cerebral infarction have an abnormal increase,and ICAM,ALCAM,VCAM,PECAM-1 level is closely related to the neurologic deficits and the severity of carotid artery plaque of type 2 diabetes mellitus complicated with acute cerebral infarction patients.
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Objective To explore the potential relationship between left coronary bifurcation angle and plaques forming in left anterior descending artery by dual-source CT angiography.Methods One hundred patients who underwent dual-source CT angiography in our hospital from January to May during 2016 and had plaques in left anterior descending artery were retrospectively studied,while 100 patients with normal image were as negative controls.There were 57 male and 43 female at the mean age of (57.54 ±-8.38) years in negative controls,and 64 male and 36 female at the mean age of (62.08 ± 13.94) years in patients with left anterior descending artery plaques.The left coronary bifurcation angle was measured by multi-planar reconstruction (MPR) and maximum density projection (MIP) techniques.Results The left coronary bifurcation angle in negative control group were range from 41.25°to 112.14°,at the mean age of 69.45 ° ± 18.71 °,while range from 54.14 ° to 128.12 o,at the mean age of 85.65 °-± 15.96 ° in plaque group.The bifurcation angle in plaque group was larger than those in negative control group(P ＜ 0.05).Conclusion Dual-source CTA could objectively evaluate left coronary bifurcation angle and plaque character.The left coronary bifurcation angle had an important influence on the formation of left anterior descending artery plaque.
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Objective To assess the value of plasma level of cystatin C(Cyst-C)and carotid artery plaque score(PS)in predicting significant coronary artery disease(SCAD)in patients with chest pain. Methods A total of 192 patients with chest pain were involved retrospectively. According to the coronary angiography results ,the patients were divided into groups of SCAD (n = 128) and non-significant coronary artery disease (NSCAD , n = 64). Analyses were done to discuss the association of Cyst-C and PS with SCAD and the predictive value of Cyst-C and PS for SCAD. Results Logistic regression analysis demonstrated that Cyst-C and PS were independent predictors of SCAD. The odds ratios(OR)associated with the Cyst-C(each 1 mg/L)and PS(each 1 mm)for prediction of SCAD were 1.329 and 1.197,respectively. The areas under the receiver-operating characteristic curves(AUC)for the Cyst-C and the PS to predict the SCAD were 0.654 and 0.688,respectively. The combination of Cyst-C and PS increased the AUC to 0.742. The optimal cut-off value of Cyst-C was 0.95 mg/L and had a sensitivity of 72.3% for SCAD. Similarly,the optimal cut-off level of PS was 3mm which presented a sensitivity of 70.7%. A Cyst-C ≥ 0.95 mg/L and a PS ≥ 3 mm had negative predictive values of 46.3% and 48.3%,respectively,for SCAD. By combining Cyst-C with PS ,the sensitivity and negative predictive value increased to 83.6%and 62.5%, respectively. Conclusions Cyst-C and PS are both correlated with SCAD. They are independent predictive factors for SCAD in patients with chest pain. Combination of Cyst-C and PS can improve the predictability ,which may increase the reliability of screening SCAD before cardiac catheterization.
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Objective To explore effect of health management on blood lipid level and carotid artery plaque in patients with carotid artery stenosis.Methods One hundred and eighty patients with carotid artery stenosis were dived divided into health management group (90 cases) and routine treatment group (90 cases).All the patients took routine treatment, and the health management were given for 12 months continuously in health management group.The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were tested, the carotid artery was checked by carotid artery color Doppler flow imaging before and at 6 months, 12 months after treatment.Results The levels of TC, TG, LDL-C in health management group and routine treatment group at 6 and 12 months after treatment were significantly decreased than those before the treatment , and the level of HDL-C were significantly increased (all P0.05).The levels of TC, TG and LDL-C at 12 months after treatment in health management group were significantly decreased than those in routine treatment group, and the level of HDL-C was significantly increased (all P0.05).The Crouse plaque integral at 12 months after treatment in health management group and routine treatment group were significantly decreased than those before the treatment (all P0.05).Crouse plaque integral at 12 months after treatment in health management group was significantly decreased than that in routine treatment group (P<0.05).Conclusion Long-term health management can decreased the level of serum lipid level and inflammation, and improve the situation of carotid artery plaque.
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Carotid ultrasound is an imaging modality that allows non-invasive assessment of vascular anatomy and function. Carotid intima-media thickness (IMT) has been shown to predict cardiovascular (CV) risk in multiple large studies. However, in 2013, American College of Cardiology/American Heart Association guidelines designated that the carotid IMT as class III evidence level was not recommended for use in clinical practice as a routine measurement of risk assessment for a first atherosclerotic CV event. Following the announcement of this guideline, combined common carotid IMT and plaque, including plaque tissue characterization and plaque burden, using 3D ultrasound was reported to be better than either measurement alone in a variety of studies. Moreover, changes in the intima thickness were related to aging and early atherosclerosis, and remodeling of the media thickness was associated with hypertension. Separate measurement is useful for evaluating the effects of different atherosclerotic risk factors on the arterial wall; however, a more detailed and elaborate technique needs to be developed. If so, separate measurement will play an important role in the assessment of atherosclerosis and arterial wall change according to a variety of risk factors, such as metabolic syndrome. In addition, although carotid blood flow velocity is a useful tool for risk classification and prediction in clinical practice, further clinical research is needed. The value of carotid IMT by ultrasound examination for risk stratification remains controversial, and groups developing future guidelines should consider the roles of plaque presence and burden and hemodynamic parameters in additional risk stratification beyond carotid IMT in clinical practice.
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Vieillissement , Athérosclérose , Vitesse du flux sanguin , Artères carotides , Artériopathies carotidiennes , Épaisseur intima-média carotidienne , Sténose carotidienne , Classification , Coeur , Hémodynamique , Hypertension artérielle , Méthodes , Appréciation des risques , Facteurs de risque , ÉchographieRésumé
Objective To investigate the relationship between the brachial‐ankle pulse wave velocity (baPWV) with the ca‐rotid arterial intima‐media thickness(IMT) and carotid artery plaque in the patients with type 2 diabetes mellitus(T2DM) and to analyze the related risk factors causing atherosclerosis .Methods A total of 426 patients with T2DM were collected and conduct the records of baPWV ,carotid artery ultrasound ,biochemical index detection andrelated risk factors record .The correlation between baPWV with carotid arterial IMT was analyzed .The patients were divided into the abnormal group and normal group according to the baPWV results .The carotid artery IMT ,carotid artery plaque and related risk factors were compared between the two groups . Results The DM duration ,systolic blood pressure ,diastolic blood pressure ,pulse pressure ,low density lipoprotein cholesterol (LDL‐C) ,number of atherosclerosis risk factors had statistically significant differences between the two groups (P0 .05) .The detection rate of plaque by carotid artery ultrasound had no statistically signifi‐cant difference between the two groups(P>0 .05);but the statistically significant difference was found in the number of plaque be‐tween the two groups(P<0 .01) ,the abnormal group was obviously more than the normal group;the normal IMT ratio had statisti‐cally significant difference between the two groups(P<0 .05) ,the normal group was obviously higher than the abnormal group .The IMT value had statistical difference between the two groups(P<0 .01) ,which in the abnormal group was significantly thickened compared with the normal group .The analysis of correlation between baPWV and IMT showed that IMT was positively correlated with baPWV(r=0 .228 ,P<0 .05) .Conclusion T2DM patients with reduced arterial elasticity could complicated with the obvious thickening of carotid arterial IMT and increase of plaque number .Combining baPWV with carotid arterial ultrasound examination can better conduct the arteriosclerosis evaluation .
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PURPOSE: To report a case of posterior ischemic optic neuropathy accompanied by carotid artery plaque in a patient with retrobulbar optic neuritis. CASE SUMMARY: A 48-year-old man visited our clinic complaining of headache, decreasing visual acuity and defect of inferior visual field in his left eye for 3 days. The best corrected visual acuity was 1.0 in the right eye and 0.1 in the left eye. The anterior segment state, intraocular pressure, fundus examination and optical coherence tomography were normal in both eyes. Relative afferent pupillary defect, color vision deficiency and total scotoma were observed in his left eye. The results of the laboratory test and brain magnetic resonance imaging were normal. He was discharged from the hospital after 3 days of systemic steroid treatment on the basis of retrobulbar optic neuritis. A week later, fluorescent angiography and carotid ultrasonography were performed because of his history memory loss and left upper limb weakness before admission. A focal filling defect of the peripapillary area was found on fluorescent angiography. A plaque with a thickness of 1.9 mm and a length of 1.4 cm was found on carotid ultrasonography. After 6 months, the best corrected visual acuity was 0.4 in the left eye and the visual field showed a partially improved defect. CONCLUSIONS: Fluorescent angiography is recommended for potential posterior ischemic optic neuropathy in patients with retrobulbar optic neuritis, even though it is rare. Carotid ultrasonography is useful in finding atherosclerosis to prevent stroke or cardiovascular disease if ischemic cause is suspected on fluorescent angiography.
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Humains , Adulte d'âge moyen , Angiographie , Athérosclérose , Encéphale , Maladies cardiovasculaires , Artères carotides , Sténose carotidienne , Troubles de la vision des couleurs , Céphalée , Pression intraoculaire , Imagerie par résonance magnétique , Troubles de la mémoire , Névrite optique , Neuropathie optique ischémique , Troubles pupillaires , Scotome , Accident vasculaire cérébral , Tomographie par cohérence optique , Échographie , Membre supérieur , Acuité visuelle , Champs visuelsRésumé
Objective To investigate the relationship betweenthe stability of carotid artery plaque and cystatin C,homocysteine. Methods A total of 1 50 cerebral infarction patients with carotid artery plaque treated in Hospital of the First Electricity Authority in Guangdong were selected as the research subjects.According to Color Doppler ultrasound scanning,the patients were divided into the observation group (86 unstable plaque patients)and control group(64 stable plaque patients).Peripheral venous blood from the patients of both groups were collected for the detection of cystatin C,homocysteine,serum total cholesterol and fibrinogen levels and the results of detection were compared between the two groups.Results The levels of cystatin C,homocysteine,serum total choles-terol and fibrinogen in the observation group were significant higher than those of the control group(t =48.760,20.530,29.860, 33.720,P <0.05).The level of cystatin C was weak positive correlated with homocysteine(r =0.21,P <0.003).Multivariate lo-gistic regression analysis showed cystatin C,homocysteine,serum total cholesterol and fibrinogen were independent risk factors for carotid artery plaque instability in patients with cerebral infarction.Conclusion Cystatin C,homocysteine,serum total cholesterol and fibrinogen are important risk factors for carotid plaque instability,the cerebral infarction is closely related to the carotid artery plaque stability,so controlling the risk factors is the focus of prevention and treatment of cerebral infarction.
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Objective To observe the effects of low frequency ultrasound on carotid artery plaque and artery stenosis. Methods 156 pa-tients with carotid atherosclerosis were divided into treatment group (n=80) and control group (n=76). The control group was administered routine medicine, while the treatment group accepted low frequency ultrasound therapy in addition. The size and shape of carotid artery plaque, severity of stenosis and the level of lipid were observed before and after treatment, and the side-effects were recorded. Results The intima-media thickness (IMT), diameter of plaque, plaque score decreased after treatment in both groups, and decreased more in the treat-ment group than in the control group (P<0.05);while the frequence of moderate stenosis and severe stenosis was less (P<0.05). The levels of low density lipoprotein-cholesterol and total cholesterol decreased in both groups after treatment (P<0.05), and decreased more in the treatment group than in the control group (P<0.05). No serious side-effect was observed. Conclusion Low frequency ultrasound can reduce the atherosclerotic plaques in carotid artery and relieve the stenosis.
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Objective To investigate the impacts of mecobalamin on plasma inflammatory factors (plasma high-sensitivity C-reactive protein (Hs-CRP) and carotid artery plaques in patients with H type hypertension.Methods Forty-eight acute ischemic stroke patients who were diagnosed with H type hypertension in the People's Hospital of Taixing were collected,and they were randomly divided them into treatment group and control group,and 24 cases of each group.Patients in both groups were given conventional therapies,including treatment of anti platelet aggregation,plaque stability and reduced plaque treatment.While patients in the treatment group were given additional oral drug of mecobalamin,500 μg each time,three times a day,6 months in all.Each case was evaluated at the second day of hospitalization,four weeks later,eight weeks later,three months and sixth months later.The examination items involved included level of plasma homocysteine(Hcy),level of hsCRP and conditions of carotid artery plaques under ultrasonography.Results Aafter four weeks,eight weeks,three months and sixth months therapy,there were significant differences between treatment group and control group in terms of Hcy (t =4.049,3.896,6.052,6.159 ; P ＜ 0.05) and the level of hs-CRP (t =37.249,28.376,26.454,0.522P ＜ 0.01).Afrter three months and sixth months therapy,compared to the control group,the carotid artery plaques were obviously reduced,and the differences were statistically significant (t =2.309,2.434 ; P ＜ 0.05).Conclusion Mecobalamin can reduce the level of plasma homocysteine,then lead to reductions of levels of plasma inflammatory factors and volume of carotid artery plaques.
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Objective To investigate the relationship between carotid arteriostenosis and atheromatous plaques with cerebral in-farction.Methods Cervical spiral CT angiography of 56 cases with cerebral infarction and 49 cases without cerebral infarction were retrospectively analysed .The difference between the two groups was compared with regard to the distribution ,nature of plaques and the degree of carotid artery stenosis.Results Of 56 patients with cerebral infarction,126 atheromatous plaques were detected in 42 patients,of which 39 were soft,34 were calcified,53 exhibited a combined nature of both calcified and soft plaque and 7 cases were plaque ulcerations (soft plaque and mixed plaque accounted for about 73%).Plaque location for carotid artery was in the bifurcation. 102 carotid arteries stenosis were found in 38 patients,which included mild stenosis in 29,moderate in 40,severe in 27 and occlusion in 6(moderate and severe stenosis accounted for about 65.7%).In the control group,28 plaques were detected in 1 1 cases,of which 6 were soft,13 were calcified and 9 exhibited a combined nature of both calcified and soft plaque.1 1 carotid arteries stenosis were found in 7 patients,included mild stenosis in 10,moderate in 1.A significant difference (P <0.05)in carotid arteriostenosis and ath-eromatous plaques between the two groups was found.Conclusion Carotid plaques and stenosis are important risk factors of cerebral infarction.Multi-slice spiral CT angiography(MSCTA)has important value in analysis of carotid artery stenosis and atheroderotic plaques.
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@#Objective To observe the effects of low frequency ultrasound on carotid artery plaque and artery stenosis. Methods 156 patients with carotid atherosclerosis were divided into treatment group (n=80) and control group (n=76). The control group was administered routine medicine, while the treatment group accepted low frequency ultrasound therapy in addition. The size and shape of carotid artery plaque, severity of stenosis and the level of lipid were observed before and after treatment, and the side-effects were recorded. Results The intima-media thickness (IMT), diameter of plaque, plaque score decreased after treatment in both groups, and decreased more in the treatment group than in the control group (P<0.05); while the frequence of moderate stenosis and severe stenosis was less (P<0.05). The levels of low density lipoprotein- cholesterol and total cholesterol decreased in both groups after treatment (P<0.05), and decreased more in the treatment group than in the control group (P<0.05). No serious side-effect was observed. Conclusion Low frequency ultrasound can reduce the atherosclerotic plaques in carotid artery and relieve the stenosis.