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Abstract Introduction Central retinal artery occlusion (CRAO) is a common cause of blindness and visual morbidity. In the majority of cases, it is related to thrombotic embolism. Nevertheless, the role of inherited or acquired thrombophilic risk factors in CRAO pathogenesis has not been comprehensively studied. Methods In 126 CRAO patients (66 [52.4%] men, median age 55 [range: 18–80] years) and 107 matched controls (56 [52.3%] men, median age 53 [range: 34–78] years) we evaluated classical atherosclerotic risk factors, including serum lipid profile and glucose level, analyzed intima-media complex thickness (IMT) of external carotid arteries, and performed transthoracic echocardiography. Furthermore, we established the prevalence of inherited and acquired thrombophilic risk factors, such as factor V Leiden (FVL) and prothrombin 20210 G/A genetic variants, plasma activity of factor (F) VIII, protein C and antithrombin activity, and free protein S levels. We also assessed the presence of antiphospholipid antibodies (APLA) and evaluated blood homocysteine in all enrolled subjects. Additionally, we estimated the occurrence of Val34Leu polymorphism of the A subunit of coagulation factor XIII (FXIII-A) in both groups as a potential thrombosis-protecting factor. Results Among traditional atherosclerotic risk components, obesity/overweight and hypercholesterolemia were the most common in the CRAO group and occurred in 103 (81.7%) and 85 (67.5%) patients, respectively. CRAO patients also had elevated IMT and altered echocardiographic parameters, indicating diastolic cardiac dysfunction. In thrombophilia investigations, at least one laboratory risk factor occurred in 72.2% (n = 91) of CRAO patients, with APLA as the most frequent, detected in 38.1% (n = 48) of them (almost seven times more frequent than in controls, p

Cardiovascular disease (CVD) is one of the ten leading causes of death worldwide. Atherosclerotic disease, which can lead to myocardial infarction and stroke, is the main cause of CVD. The two main ultrasound image phenotypes used to monitor atherosclerotic load are carotid intima-media thickness (IMT) and plaque area (PA). Early segmentation and measurement methods were based on manual or threshold segmentation, snake models, etc. Usually, these methods are semi-automatic and have poor repeatability and accuracy. Segmentation of the carotid intima-media complex (IMC) and plaque in ultrasound based on artificial intelligence can achieve good accuracy. Compared with two-dimensional ultrasound, three-dimensional/four-dimensional ultrasound can provide spatial dynamic vascular information, which is helpful for doctors to evaluate. This study reviews the progress of artificial intelligence (AI) segmentation methods based on machine learning (ML) and deep learning (DL) used in the segmentation of the IMC and plaque as well as the 3D / 4D reconstruction of carotid ultrasound.

Objective: To assess the carotid intima-media thickness and cardiovascular risk factors in patients with benign prostatic hyperplasia. Material and methods: This was a prospective observational study conducted over two years in 100 patients who presented with benign prostatic hyperplasia (BPH). IPSS questionnaire was used to evaluate the symptomatology of BPH. Patients were examined for cardiovascular risk factors. All patients underwent echocardiographic examination for left ventricular function. A single experienced sonographer, blinded to all clinical information, assessed the common carotid artery. Results: The patients mean age was 69.32 years. The mean BMI was 28.91 kg/m². Of the total mild symptom score cases, 75 % (N=6) cases had Grade I prostatomegaly (26 – 40 cc). 98.38 % (N=61) cases had Grade II prostatomegaly (41 – 60 cc), 93.33 % (N=28) cases had Grade III prostatomegaly (>60cc). A mean carotid intima-media thickness (IMT) of 0.56 mm was found in cases having mild IPSS scores (Score 1-7), 0.73 mm was found in cases having moderate IPSS score (Score 8-19), 0.92 mm was found in cases having severe IPSS scores (Score 20-35). Significant association was present between mean BMI, diabetes mellitus, hypertension, hyperlipidemia, smoking and mean Carotid IMT with IPSS as p-value was Conclusion: This study found that prostatic tissue had a strong relationship with carotid IMT and cardiovascular risk factors in BPH patients. These data suggest a possible link between carotid IMT and cardiovascular risk factors and BPH.

Background We investigated how childhood‐to‐adulthood perceived stress patterns predict adult cardiometabolic risk. Methods and Results This study included 276 participants from the Southern California Children's Health Study (2003–2014), and a follow‐up assessment (2018–2021). Perceived stress (Perceived Stress Scale) was initially reported by participants' parents for themselves during early childhood (mean age, 6.3 years), and later self‐reported during adolescence (13.3 years) and young adulthood (23.6 years). Participants were grouped into 4 stress patterns: consistently high, decreasing, increasing, and consistently low. Cardiometabolic risk was assessed in young adulthood by carotid artery intima‐media thickness, systolic and diastolic blood pressure, obesity, percent body fat, android/gynoid ratio, and glycated hemoglobin. A cardiometabolic risk score was generated by summing the clinically abnormal markers. Multivariable linear and logistic regression models were used to (1) examine the associations between Perceived Stress Scale at 3 time points and adult cardiometabolic risk, and (2) assess the impact of stress pattern on adult cardiometabolic risk. Findings suggested that in adulthood, higher Perceived Stress Scale score was associated with increased overall cardiometabolic risk (β=0.12 [95% CI, 0.01–0.22]), carotid artery intima‐media thickness (β=0.01 [95% CI, 0.0003–0.02]), systolic blood pressure (β=1.27 [95% CI, 0.09–2.45]), and diastolic blood pressure (β=0.94 [95% CI, 0.13–1.75]). Individuals with a consistently high adolescence‐to‐adulthood stress pattern had greater overall cardiometabolic risk (β=0.31 [95% CI, 0.02–0.60]), android/gynoid ratio (β=0.07 [95% CI, 0.02–0.13]), percent body fat (β=2.59 [95% CI, 0.01–5.17]), and greater odds of obesity (odds ratio, 5.57 [95% CI, 1.62–19.10]) in adulthood, compared with those with a consistently low Perceived Stress Scale score. Conclusions Consistently high perceived stress from adolescence to adulthood may contribute to greater cardiometabolic risk in young adulthood.

Background: Advanced glycation end products (AGEs) have been linked to cardiovascular disease (CVD), especially coronary heart disease (CHD), but their role in CVD pathogenesis remains unclear. Therefore, we investigated cross-sectional associations of skin AGEs with subclinical atherosclerosis, arterial stiffness, and hypertension after confirming their relation with CHD. Methods: In the population-based Rotterdam Study, skin AGEs were measured as skin autofluorescence (SAF). Prevalent MI was obtained from digital medical records. Carotid plaques, carotid intima-media thickness (IMT), coronary artery calcification (CAC), pulse wave velocity (PWV), and hypertension were assessed. Associations of SAF with endophenotypes were investigated in logistic and linear regression models adjusting for common cardiovascular risk factors. Effect modification by sex, diabetes mellitus, and chronic kidney disease (CKD) was tested. Results: 3001 participants were included (mean age 73 (SD 9) years, 57% women). One unit higher SAF was associated with the presence of carotid plaques (OR 1.2 (0.92, 1.57)), a higher max IMT (0.08 SD (0.01, 0.15)), higher CAC (OR 2.2 (1.39, 3.48)), and PWV (0.09 SD (0.01, 0.16)), but not with hypertension (OR 0.99 (0.81, 1.21)). The associations with endophenotypes were more pronounced in men and participants with diabetes or CKD with significant interactions. Conclusions: Previously documented associations between SAF and CVD, also found in our study, may be explained by the endophenotypes atherosclerosis and arterial stiffness, especially in men and individuals with diabetes or CKD, but not by hypertension. Longitudinal studies are needed to replicate these findings and to test if SAF is an independent risk factor or biomarker of CVD. Trial registration: The Rotterdam Study has been entered into the Netherlands National Trial Register (NTR; www.trialregister.nl) and the WHO International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/network/primary/en/) under shared catalogue number NTR6831. [ABSTRACT FROM AUTHOR]

Background and Objectives: Lipid-lowering agents such as ezetimibe are recommended in uncontrolled hyperlipidemia for primary and secondary prevention of cardiovascular disease. Carotid intima-media thickness (CIMT) is a surrogate marker of atherosclerosis and a predictor of cardiovascular and cerebral events. The effects of ezetimibe on CIMT have been inconsistently reported. The aim of this meta-analysis is to compare the effects of ezetimibe/statin and statin alone therapies on CIMT reduction. Materials and Methods: The PubMed, Embase, and Cochrane library databases were searched for randomized controlled trials (RCTs) published prior to 26 January 2023 with the MeSH keywords 'Ezetimibe' and 'Carotid Intima-Media Thickness'. The results were presented as standard mean difference (SMD) with 95% confidence intervals using the random-effect model method, and heterogeneity was assessed. Subgroup, meta-regression, and sensitivity analyses were conducted. Results: Five RCTs with 642 participants were included. CIMT reduction was not significantly different between the ezetimibe/statin and statin alone groups. However, in subgroup analyses, CIMT in the ezetimibe/statin group was significantly reduced in patients with non-familial hypercholesterolemia (SMD: −0.34 mm and p = 0.002) and in patients with secondary prevention (SMD: −0.38 mm and p = 0.002). The low-density lipoprotein cholesterol level was significantly reduced in the ezetimibe/statin group (SMD: −0.58 mg/dL and p < 0.001). Conclusions: The effect of ezetimibe on CIMT reduction was shown in non-familial hypercholesterolemia and secondary prevention. These results suggest that the efficacy of ezetimibe may vary with potential CIMT reduction benefits in certain subpopulations. [ABSTRACT FROM AUTHOR]

Objectives: Fabry disease (FD) is a rare X‐linked lysosomal storage disorder with variable phenotypes, including neurological symptoms. These can be influenced by vascular impairment. Extracranial and transcranial vascular sonography is an effective and noninvasive method for measuring arterial structures and blood flow. The study aims to investigate cerebrovascular phenotype characteristics in FD patients compared to controls using neurosonology. Methods: This is a single‐center, cross‐sectional study of 130 subjects—65 patients (38 females), with genetically confirmed FD, and 65 sex‐ and age‐matched controls. Using ultrasonography, we measured structural and hemodynamic parameters, including distal common carotid artery intima‐media thickness, inner vertebral artery diameter, resting blood flow velocity, pulsatility index, and cerebral vasoreactivity (CVR) in the middle cerebral artery. To assess differences between FD and controls and to identify factors influencing investigated outcomes, unadjusted and adjusted regression analyses were performed. Results: In comparison to sex‐ and age‐matched controls, FD patients displayed significantly increased carotid artery intima‐media thickness (observed FD 0.69 ± 0.13 mm versus controls 0.63 ± 0.12 mm; Padj =.0014), vertebral artery diameter (observed FD 3.59 ± 0.35 mm versus controls 3.38 ± 0.33 mm; Padj =.0002), middle cerebral artery pulsatility index (observed FD 0.98 ± 0.19 versus controls 0.87 ± 0.11; Padj <.0001), and significantly decreased CVR (observed FD 1.21 ± 0.49 versus controls 1.35 ± 0.38; Padj =.0409), when adjusted by age, BMI, and sex. Additionally, FD patients had significantly more variable CVR (0.48 ± 0.25 versus 0.21 ± 0.14; Padj <.0001). Conclusions: Our results suggest the presence of multiple vascular abnormalities and changes in hemodynamic parameters of cerebral arteries in patients with FD. [ABSTRACT FROM AUTHOR]

Objective: Behçet's disease (BD) is a chronic multisystem inflammatory disease of unknown etiology defined as recurrent aphthous oral and genital ulcers, skin lesions, and uveitis. BD is a type of systemic vasculitis that can affect arteries regardless of origin and size-the co-occurrence of chronic systemic vasculitis and acute systemic inflammation results in an endothelial abnormality of the vessels. The morphological thickness of the arterial wall is a crucial feature of atherosclerosis. Carotid intima-media thickness (IMT) is an endothelial cell dysfunction parameter associated with atherosclerosis. This study aimed to evaluate the hemodynamic properties of carotid-vertebral and renal arteries of BD with cutaneous lesions to prove the effects of subclinical morphology of atherosclerosis. Methods: The study consisted of 23 BD patients with oral and genital aphthae or cutaneous lesions. Color Doppler and B-mode ultrasonography examinations of the carotid-vertebral and renal arteries were performed in all patients. The assessment of the vascular structures included IMT, plaque thickness, resistive index, pulsatility index, peak systolic velocity, end-diastolic velocity, and the volumes of both kidneys were measured in the study. In addition, the flow rates of both vertebral arteries were calculated. Results: The most intriguing findings of our study were the detection of non-stenotic plaque in 3 patients, mild intimal thickening in most patients, and vertebra basilar insufficiency in 12 patients. In addition, hemodynamic alterations of the patient's carotid arteries were compatible with the reported findings in the literature. Age, gender, disease duration, ophthalmic and neurological involvement, and IMT correlation were evaluated with the chi-square test, and no statistically significant correlation was found in this study. However, in the Mann-Whitney U test, a significant positive correlation was detected between kidney volume and IMT (p<0.035). Conclusion: We found no significant differences in vascular changes secondary to early atherosclerosis compared with the average population and literature in Behçet patients with cutaneous lesions. The increase in kidney size may be one of the early signs of atherosclerosis in Behçet's cases. [ABSTRACT FROM AUTHOR]

Introduction: Remnant cholesterol is a risk factor for cardiovascular disease, especially when low-density lipoprotein cholesterol (LDL-C) levels are normal. However, there are few studies on the relationship between remnant cholesterol and subclinical atherosclerosis. Common carotid artery intima-media thickness (cIMT) is an imaging marker of subclinical atherosclerosis. This study aimed to investigate the relationship between remnant cholesterol and cIMT in a community population with normal LDL-C. Methods: This study is a retrospective analysis; 1,101 community population with available carotid artery imaging and fasting lipid data with LDL-C <4.1 mmol/L were included in this analysis. Remnant cholesterol was calculated as total cholesterol minus LDL-C minus high-density lipoprotein cholesterol. Abnormal cIMT was defined as maximum cIMT value ≥1 mm. Logistic regression was used to assess the relationships between remnant cholesterol levels and abnormal cIMT. Results: As the remnant cholesterol level increased from the lowest to the highest quartile, the rate of abnormal cIMT increased from 24.5% to 38.6% (p trend <0.001) in the community population with normal LDL-C level. In the unadjusted model, the odds ratios (ORs, 95% confidence intervals) in the highest quartile group were 1.937 (1.338–2.803) for abnormal cIMT compared with the lowest quartile. The multivariable-adjusted ORs (95% confidence intervals) for the highest versus lowest quartile of remnant cholesterol were 2.132 (1.420–3.202) for abnormal cIMT. Conclusion: Elevated fasting remnant cholesterol levels were positively associated with abnormal cIMT in community population with normal LDL-C levels. Remnant cholesterol may be an important indicator of risk stratification in community population with normal LDL-C level. [ABSTRACT FROM AUTHOR]

Background/Aim: Vascular age (VA) is an emerging metric in preventive cardiovascular (CV) medicine. VA can be derived from morphological parameters such as carotid intimamedia thickness (CIMT), or functional parameters such as pulse wave analysis (PWA), which celebrates its 100th birthday. This study aimed to investigate whether the results of both approaches are comparable. Patients and Methods: On the occasion of the double 100th anniversary of PWA and the Mannheim Clinic, 100 volunteers underwent a) bilateral CIMT assessment using high-resolution ultrasound and b) oscillometric PWA at the brachial forearm site. The respective VAs were calculated using previously published equations. Results: Median age of the participants was 53.6 years (range=39.8-62.6 years), and 56% were female. Median CIMT was 632.5 μm (range=548.8-730.0 μm). Median PWA-derived VA was 55.3 years (36.5-70.5 years). Different values were obtained for CIMT-derived VA, depending on the reference cohort used as calculation basis, ranging from median 43.7 (26.2-59.5 years) to median 64.0 years (43.5-82.1 years). In 46% of the participants divergent VAs were found, that is, the calculated age was higher according to one method and lower according to the other. Correlation analysis revealed a strong dependence of VA (both PWA- and CIMT-derived) and chronological age, as well as an increase in CV risk factors and the detection of plaques with age. Conclusion: Different approaches for estimating VA are not comparable and often produce contradictory results. The current methods and their validity must be critically assessed if they are not standardized. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) is associated with significant mortality and morbidity. Atherosclerosis is the most common pathophysiology behind this condition. This manifests as an increase in arterial wall intima-media thickness and subsequent plaque formation in the asymptomatic phase. Objectives: To measure the carotid intima-media thickness (CIMT) value of carotid arteries in patients with angiographically diagnosed CAD and also asses the carotids for the presence of plaques and if present to characterize them. Materials and Methods: A total of 100 angiographically diagnosed CAD patients were included in the descriptive study and data were analyzed regarding the increased CIMT, and plaques in the carotid arteries in relation to the corresponding coronary disease. Results: Raised CIMT values were found in 47 out of 100 patients. A linear proportional relationship of mean CIMT values with the number of involved coronary arteries was also observed. A total of 62 plaques were demonstrated in 43 patients. Majority of the plaques (65%) had a smooth surface with uniform outlines. Eighteen plaques were found to have irregular surface outlines (29%), whereas four out of 62 plaques (6%) had ulcerated surfaces. Conclusion: There is increased CIMT prevalence and its linear proportional relationship with an increased number of affected coronary vessels in patients with CAD. Furthermore, an increased prevalence of carotid plaques is present in these patients. Hence, the increased CIMT and the presence of carotid plaques may act as surrogate markers for risk stratification in a patient with CAD.

Background: The aim was examination of the intimamedia thickness of carotid arteries in COVID-19 infection. Methods: In 50 patients, the thickness of the intimomedial complex (IMT) in the common carotid arteries was measured. The values were compared with the control group in 2006-9. The condition of the lungs was assessed by ultrasound score (It score) (0-42) as mild (0-14) or mediumsevere (15-28) Covid. IMT thickening risk factors and the value of fibrinogen, IL-6 and CRP were recorded. Two IMT prediction models were formed. The socio-epidemiological model predicts the development of IMT based on epidemiological factors. Apart from these factors, the second model also includes the values of the mentioned biomarkers. Results: It score 20±6, IMT values right: median 0.99 mm, p25=0.89, p75=1.14; left: 1±0.22 mm. Control: IMTright: median 0.7 mm, p25=0.68 mm; p75=0-9 mm; left: median=0.75 mm, p25=0.6 mm, p75=1.0 mm. The group/control difference is highly significant. Epide mio - logical model: logit (IMT)= 4.463+(2.021+value for GEN)+(0.055x AGE value)+(-3.419x RF value)+(-4.447x SM value)+(5.115x HTA value)+(3.56x DM value)+ (22.389x LIP value)+(24.206x CVD value)+(1.449x other value)+(-0.138x It score value)+(0.19xBMI value). Epidemiological-inflammatory model: logit (IMT)=5.204+ (2.545x GEN value)+(0.076x AGE value)+(-6.132x RF value)+(-7.583x SM value)+(8.744x HTA value)+(6.838x DM value)+(25.446x LIP value)+(28.825x CVD value)+ (2.487x other value)+(-0.218xIt score value)+(0.649x BMI value) +(-0.194x fibrinogen value)+(0.894x IL-6 value)+(0.659x CRP value). Values for both models Exp(B)=4.882; P of sample=0.83; logit=-0.19; OR= 23.84; model accuracy for the first model 87% and for the second 88%; Omnibus test of the first model c2=34.324; p=0.000; reliability coefficient -2LogLH=56.854; Omnibus test of the second model c2=39.774; p=0.000; and -2LogLH=51.403. Conclusions: The ageing of blood vessels in COVID-19 can be predicted.

There is a lack of consensus about the association between psoriasis (PSO) and carotid intima-media thickness (cIMT) in literature, since previous studies considered dermatologic clinic patients or general population. This study aimed to compare cIMT levels according to PSO in a sample of 10,530 civil servants form the ELSA-Brasil cohort study and analyze its association with the disease. The PSO cases and disease duration were identified by medical diagnosis self-reported at study enrollment. A paired group was identified by propensity score matching among all the participants without PSO. Mean cIMT values were considered for continuous analysis while cIMT above 75th percentile was considered for categorical analysis. Multivariate conditional regression models were used to analyze association between cIMT and PSO diagnosis, by comparing PSO cases against paired controls and overall sample without disease. A total of n = 162 PSO cases were identified (1.54%) and no difference in cIMT values was observed between participants with PSO and overall sample or control group. PSO was not associated with linear increment of cIMT (vs. overall sample: β = 0.003, p = 0.690; vs. matched controls: β = 0.004, p = 0.633) neither with increased chance of having cIMT above 75th percentile (vs. overall sample: OR = 1.06, p = 0.777; vs. matched controls: OR = 1.19, p = 0.432; conditional regression: OR = 1.31, p = 0.254). There was no relationship between disease duration and cIMT (β = 0.000, p = 0.627). Although no significant relationship between mild cases of psoriasis and cIMT was observed among a wide cohort of civil servants, longitudinal investigation about cIMT progression and severity of disease are still needed. [ABSTRACT FROM AUTHOR]

Background and aimPre-eclampsia (PE) is related to elevated blood pressure (BP) in children. The study aims to investigate if elevated BP is reflected in child arterial health and how anthropometrics, body composition, and gestational and perinatal factors influenced this.MethodsIn this prospective cohort study, we assessed the arteries of 182 children exposed (46 had an early onset, with a diagnosis before 34 gestational weeks, and 136 had a late onset) and 85 children unexposed (non-PE) to PE at 8–12 years from delivery using ultra-high-frequency ultrasound in addition to ambulatory and central BPs, body composition and anthropometrics, and tonometry-derived pulse wave velocity (PWV).ResultsNo differences were found in intima-media thickness (IMT), adventitia thickness (AT), lumen diameter (LD), local carotid artery stiffness, distensibility, or wall stress between PE-exposed and non-PE-exposed children. All children's brachial, radial, and femoral artery IMTs were associated with 24-h systolic BP (SBP) and pulse pressure, carotid–femoral PWV, and anthropometric measures. The 24-h SBP and anthropometrics, notably lean body mass, were independent predictors of peripheral artery IMTs (brachial R2 = 0.217, radial R2 = 0.208, femoral R2 = 0.214; p

Introduction: Central retinal artery occlusion (CRAO) is a common cause of blindness and visual morbidity. In the majority of cases, it is related to thrombotic embolism. Nevertheless, the role of inherited or acquired thrombophilic risk factors in CRAO pathogenesis has not been comprehensively studied. Methods: In 126 CRAO patients (66 [52.4%] men, median age 55 [range: 18–80] years) and 107 matched controls (56 [52.3%] men, median age 53 [range: 34–78] years) we evaluated classical atherosclerotic risk factors, including serum lipid profile and glucose level, analyzed intima-media complex thickness (IMT) of external carotid arteries, and performed transthoracic echocardiography. Furthermore, we established the prevalence of inherited and acquired thrombophilic risk factors, such as factor V Leiden (FVL) and prothrombin 20210 G/A genetic variants, plasma activity of factor (F) VIII, protein C and antithrombin activity, and free protein S levels. We also assessed the presence of antiphospholipid antibodies (APLA) and evaluated blood homocysteine in all enrolled subjects. Additionally, we estimated the occurrence of Val34Leu polymorphism of the A subunit of coagulation factor XIII (FXIII-A) in both groups as a potential thrombosis-protecting factor. Results: Among traditional atherosclerotic risk components, obesity/overweight and hypercholesterolemia were the most common in the CRAO group and occurred in 103 (81.7%) and 85 (67.5%) patients, respectively. CRAO patients also had elevated IMT and altered echocardiographic parameters, indicating diastolic cardiac dysfunction. In thrombophilia investigations, at least one laboratory risk factor occurred in 72.2% (n = 91) of CRAO patients, with APLA as the most frequent, detected in 38.1% (n = 48) of them (almost seven times more frequent than in controls, p < 0.001). Deficiencies in protein C activity and free protein S levels were also common in the CRAO group, reported in 17.5% (n = 22) and 19.8% (n = 25) of patients, respectively. Interestingly, among two analyzed prothrombotic genetic variants, only the FVL was related to CRAO, with the allelic frequency 2.4 times more prevalent than in controls (p = 0.044). Finally, the CRAO group was characterized by hyperhomocysteinemia, almost twice as common as in controls (p = 0.026). Antithrombin deficiency, elevated FVIII, and FXIII-A Val34Leu polymorphism were not associated with CRAO. Conclusions: Our findings suggest that thrombophilia plays a vital role in the pathogenesis of CRAO. Thus, proper laboratory screening should be considered in the primary and secondary prevention of those episodes, with implementing appropriate therapy as needed. [ABSTRACT FROM AUTHOR]

Background: The carotid intima-media thickness (CIMT) is uniformly regarded as a consistent noninvasive marker for subclinical atherosclerosis and is widely accepted for assessment of cardiovascular risk in high-risk individuals including diabetes. Objectives: The present study was conducted to estimate the CIMT in prediabetes, new-onset type 2 diabetes mellitus (T2DM), and those with disease of at least 5-year duration to analyze its relationship to this common metabolic disorder and other risk factors. Materials and Methods: This was a cross-sectional hospital-based study conducted on 75 patients, 25 in each Group A (with T2DM of more than 5-year duration), Group B (new-onset T2DM), and Group C (prediabetes). IMT was measured in common carotid artery (CCA) bilaterally using high-resolution B-mode ultrasound. Continuous variables in the three groups were evaluated by analysis of variance, and CIMT was correlated with glycosylated hemoglobin (HbA1c) and lipid profile by Pearson's correlation. Results: The mean CIMT in the right CCA was 0.67 + 0.12 mm, 0.58 + 0.07 mm, and 0.53 + 0.07 mm and in the left CCA was 0.65 + 0.10 mm, 0.58 + 0.06 mm, and 0.54 + 0.07 mm in Groups A, B, and C, respectively. A statistically significant difference was observed between Group A and Group B as well as between Group A and Group C (P < 0.05). Patients with diabetes (DM) who had disease of over 5-year duration and relatively poor control of blood glucose (high HbA1c), and dyslipidemia, had significantly higher CIMT values than those with new-onset DM as well as prediabetes. Conclusion: All the three subgroups of dysglycemic individuals had higher CIMT as compared to historical data from healthy Asian Indian population. The CIMT values increased along the temporal continuum of hyperglycemia, being the lowest in individuals with prediabetes to the highest values in DM of at least 5-year duration. This indicates that subclinical atherosclerosis has an onset early in DM and CIMT has a linear relationship with the progression of hyperglycemia. [ABSTRACT FROM AUTHOR]

Background and Objectives: The role of adipokines in the development of atherosclerosis in type 2 diabetes (T2DM) has not yet been fully elucidated. The effects of drugs on adipokine concentrations have only been evaluated in very few studies, although they may be of clinical importance. This study aimed to assess whether the concentrations of circulating adipokines could predict subclinical atherosclerosis in patients with T2DM, as well as their interactions with commonly used cardiovascular drugs. Materials and Methods: Our population-based cross-sectional multicentric study included 216 participants with T2DM but without previously diagnosed atherosclerosis. The carotid artery intima–media thickness (IMT), plaque and ankle–brachial index (ABI) metrics were measured. Resistin, visfatin, retinol-binding protein 4, high molecular weight adiponectin and leptin levels were evaluated using Luminex's xMAP technology. Results: Visfatin and resistin concentrations correlated positively with IMT (p = 0.002 and p = 0.009, respectively). The correlation of visfatin to IMT ≥ 1.0 mm was significant in males (p < 0.001). Visfatin had a positive correlation with IMT ≥ 1.0 mm or plaque (p = 0.008) but resistin only correlated with plaque (p = 0.049). Visfatin predicted IMT ≥ 1.0 mm or plaque in patients on β-blocker monotherapy (p = 0.031). Visfatin lost its ability to predict subclinical atherosclerosis in patients taking angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers or statins. After adjustments for risk factors for atherosclerosis and cardiovascular drugs, visfatin maintained an independent association with mean IMT (p = 0.003), IMT ≥ 1.0 mm or plaque (p = 0.005) and ABI ≤ 0.9 (p = 0.029). Conclusions: Visfatin could be used as a marker of subclinical atherosclerosis in patients with T2DM, especially in males. The assessment of visfatin concentration could aid in identifying individuals who could benefit from implementing preventive measures against atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Existing evidence suggests a close link among high levels of serum urate (SU), obesity and carotid atherosclerosis. The aim of the present study was to evaluate the interrelations between SU levels and carotid atherosclerosis in subjects with different obesity phenotypes. Methods: In this study, a total of 2076 subjects (mean age 48.1 ± 13.1 years; 1307 women) were recruited: 59 with general obesity, 616 with central obesity, 715 with mixed (general–central) obesity and 686 non-obese. Anthropometric measurements, vascular risk factors, blood biochemistry analysis (including SU levels), and carotid ultrasound were performed. Ultrasound assessment included evaluation of intima-media thickness (IMT) and plaque characteristics, including number, total area and type (vulnerable vs. stable) of plaques. Results: After adjustment for potential confounders, the highest levels of SU were observed in subjects with mixed obesity, followed by subjects with central obesity, general obesity and the non-obese (309.4 ± 82.2 vs. 301.2 ± 73.1 vs. 272.9 ± 61.8 vs. 234.2 ± 59.8 μmol/L, respectively; F = 149.2, post hoc p < 0.001). Similarly, subjects with mixed and central obesity presented higher values of IMT compared to subjects with general obesity and the non-obese (0.68 ± 0.16 vs. 0.67 ± 0.16 vs. 0.62 ± 0.14 vs. 0.57 ± 0.13 mm, respectively; F = 54.2, post hoc p < 0.001). No difference in number, total area and type of plaques among obesity groups were attested (all p > 0.05). Significantly higher IMT values were observed in subjects with increased SU levels compared to subjects with normal SU levels (0.70 ± 0.10 vs. 0.62 ± 0.14 mm, p = 0.02) only within the central obesity group. Increasing levels of SU were associated with a higher frequency of increased IMT only in subjects with central obesity (OR 1.033, 95% CI 1.025–1.041). Similarly, SU levels yielded a satisfactory performance in detecting subjects with increased IMT (AUC 0.65, 95% CI 0.50–0.73, subjects with carotid plaques (0.62, 95% CI 0.55–0.68) and subjects with vulnerable plaque types (0.68, 0.59–0.76) only within the central obesity group. Conclusions: Among the studied obesity types, the association between SU levels and markers of carotid atherosclerosis was of particular significance in subjects with central obesity. [ABSTRACT FROM AUTHOR]

Haemoglobin A1c (HbA1c) levels have been shown to be related to carotid artery plaques. However, studies on the relationship between HbA1c levels and carotid artery plaques in patients with coronary heart disease (CHD) are limited and inconsistent. Our objective was to examine the correlation between HbA1c levels and carotid artery plaques in patients with CHD. The study comprised 9275 Chinese adults with CHD from January 1, 2014, to September 30, 2020. HbA1c levels were assessed, and colour Doppler ultrasound was used to evaluate the carotid artery, including plaque presence, intima-media thickness, and plaque echo properties, to investigate the association between HbA1c and carotid plaque. A logistic regression model was used to assess the association between carotid artery plaques, carotid plaque echogenicity, and HbA1c. The HbA1c level of the plaque-present group was higher than that of the plaque-absent group [6.1 (5.6–7.2) vs. 5.8 (5.5–6.5), p < 0.001]. In multiple linear regression analysis, intima-media thickness was associated with HbA1c (p < 0.001). Logistic regression showed that a higher HbA1c level was associated with plaque incidence as well as hyperechoic and heterogeneous plaques (p < 0.001). These associations persist after adjusting for age, sex, blood pressure, lipid profiles, alcohol consumption, and tobacco exposure. HbA1c levels are notably associated with carotid artery plaque incidence, intima-media thickness, and plaque echogenicity in patients with CHD. These findings show that different levels of HbA1c may be an indicator for carotid artery plaques and thus, should be observed in patients with CHD. [ABSTRACT FROM AUTHOR]

Several noninvasive vascular biomarkers have been proposed to improve risk stratification for atherothrombotic events. To identify biomarkers suitable for detecting intermediate-risk individuals who might benefit from lipid-lowering treatment in primary prevention, the present study tested the association of plasma LDL-cholesterol with coronary artery calcification (CAC) Agatston score, high carotid and femoral intima-media thickness (IMT), low carotid distensibility and high carotid-femoral pulse-wave velocity in 260 asymptomatic individuals at intermediate cardiovascular risk and without diabetes and lipid-lowering treatment. High or low vascular biomarkers were considered when their value was above the 95th or below the 5th percentile, respectively, of the distribution in the healthy or in the study population. LDL-cholesterol was independently associated with the CAC score = 0 (OR 0.67; 95%CI 0.48–0.92, p = 0.01), CAC score > 100 (1.59; 1.08–2.39, p = 0.01) and high common femoral artery (CFA) IMT (1.89; 1.19–3.06, p < 0.01), but not with other biomarkers. Our data confirm that in individuals at intermediate risk, lipid-lowering treatment can be avoided in the presence of a CAC score = 0, while it should be used with a CAC score > 100. CFA IMT could represent a useful biomarker for decisions regarding lipid-lowering treatment. However, sex- and age-specific reference values should be established in a large healthy population. [ABSTRACT FROM AUTHOR]

Background and Objectives. Optimal nutrition for type 2 diabetes (T2DM) aims to improve glycemic control by promoting weight loss and reducing adipose tissue, consequently improving cardiovascular health. Dietary alterations can influence adipose tissue metabolism and potentially impact adipocytokines like visfatin, thereby affecting atherosclerosis development. This study aimed to investigate dietary habits and adherence to recommendations among individuals with T2DM and to examine how dietary adherence influences the association between visfatin and subclinical atherosclerosis. Materials and Methods: This cross-sectional multicenter study involved 216 adults (30–70 years) with T2DM, assessing dietary habits, adherence to recommendations (carbohydrates, fats, protein, fiber, saturated fatty acid, polyunsaturated and monounsaturated fatty acid (PUFA and MUFA) and salt), and the association between visfatin and subclinical atherosclerosis. Participants completed 24 h dietary recalls; dietary misreporting was assessed using the Goldberg cut-off method. Carotid intima–media thickness (IMT) and plaque occurrence were evaluated with ultrasound, while visfatin levels were measured using Luminex’s xMAP technology. Results: Three of the eight recommendations were followed in 31% of subjects, two in 26%, and four in 20%, with the highest adherence to MUFA and protein intake. Significant correlations between IMT and visfatin were observed in individuals with specific dietary patterns. The association between IMT and visfatin persisted when PUFA and MUFA intake aligned with recommendations. PUFA intake ≤ 10% and MUFA ≤ 20% of total energy significantly correlated with carotid artery IMT (p = 0.010 and p = 0.006, respectively). Visfatin’s associations with IMT remained significant (p = 0.006) after adjusting for common risk factors, medication use, and dietary nonadherence. No association was observed with carotid artery plaque. Conclusions: Dietary compliance was limited, as only 31% adhered even to three of eight recommendations. A common dietary pattern characterized by low carbohydrate and fiber but high fat, total fat, saturated fat, and salt intake was identified. This pattern amplifies the statistical association between visfatin and subclinical atherosclerosis.

Background: Several markers have been proposed for the detection and progression of subclinical atherosclerosis. We aimed to analyse the impact of classical risk factors on the presence and short-term progression of subclinical carotid atherosclerosis in a non-diabetic, primary prevention cohort. Methods: This analysis included participants with completed visits at baseline and at 5-year follow-up (N = 141; 56.7% females, 43.3% males; aged 49.6 ± 4.7 years). Clinical and laboratory parameters, risk profiles, carotid artery intima-media thickness (CIMT) and plaque presence were analysed. Results: There was a significant progression in mean CIMT (0.54 ± 0.09 mm–0.62 ± 0.10 mm; p < 0.001), prevalence of carotid plaque (4.8%–17.9%; p < 0.001) and age- and sex-adjusted abnormal CIMT (52.9%–78.8%; p < 0.001) at the end of follow-up, compared to baseline. In multivariate regression analysis, among the classical risk factors, their number, metabolic syndrome and SCORE (Systematic Coronary Risk Estimation) risk only the number of risk factors showed an independent and significant impact on the occurrence of a carotid plaque (Exp(B) = 1.71; p = 0.017) and 5-year CIMT progression. Conclusions: During a short follow-up, the significant progression of subclinical atherosclerosis was confirmed. The number of risk factors predicted the occurrence of carotid plaques and CIMT progression. The high prevalence and short-term progression of subclinical carotid atherosclerosis underly the rationale for its screening in personalized cardiovascular risk stratification in asymptomatic middle-aged subjects over 50 years old, at low-to moderate cardiovascular risk, particularly with several risk factors.

Echolucency, a measure of plaque instability associated with increased cardiovascular risk, can be assessed in both the carotid plaque and the plaque-free common carotid intima–media (IM) complex as a gray-scale median (plaque-GSM and IM-GSM, respectively). The impact of specific vascular risk factors on these two phenotypes remains uncertain, including the nature and extent of their influence. This study aims to seek the determinants of plaque-GSM and IM-GSM. Plaque-GSM and IM-GSM were measured in subjects from the IMPROVE study cohort (aged 54–79, 46% men) recruited in five European countries. Plaque-GSM was measured in subjects who had at least one IMTmax ≥ 1.5 mm (n = 2138), whereas IM-GSM was measured in all subjects included in the study (n = 3188). Multiple regression with internal cross-validation was used to find independent predictors of plaque-GSM and IM-GSM. Plaque-GSM determinants were plaque-size (IMTmax), and diastolic blood pressure. IM-GSM determinants were the thickness of plaque-free common carotid intima–media complex (PF CC-IMTmean), height, systolic blood pressure, waist/hip ratio, treatment with fibrates, mean corpuscular volume, treatment with alpha-2 inhibitors (sartans), educational level, and creatinine. Latitude, and pack-yearscode were determinants of both plaque-GSM and IM-GSM. The overall models explain 12.0% of plaque-GSM variability and 19.7% of IM-GSM variability. A significant correlation (r = 0.51) was found between plaque-GSM and IM-GSM. Our results indicate that IM-GSM is a weighty risk marker alternative to plaque-GSM, offering the advantage of being readily measurable in all subjects, including those in the early phases of atherosclerosis where plaque occurrence is relatively infrequent.

Purpose: Restless legs syndrome is claimed to be associated with a higher risk of cardiovascular diseases. Intima-media thickness has been reported to be the most valuable surrogate marker and predictor of atherosclerosis progression and upcoming cardiovascular diseases. In this study, we aimed to evaluate the relationship between restless legs syndrome and intima-media thickness of the carotid artery. Materials and Methods: In this case-control study, a total of 23 patients with restless legs syndrome without other known risk factors of cardiovascular diseases were evaluated with regard to the intima-media thickness of the carotid artery by employing a high-resolution B-mode ultrasound study. The findings of the ultrasound study between the case and the control group were compared and statistically analyzed. Results: Intima-media thickness was revealed to be of a lower value in subjects with restless legs syndrome (0.79±0.10) compared to the control group (0.88±0.13). Also, our study showed that older age and the presence of hypertension directly correlates with intima-media thickness. Conclusion: It can be concluded that restless legs syndrome is associated with a lower intima-media thickness.

Objective: We investigated the associations between physical activity (PA) and cardiorespiratory fitness (CRF) with vascular health phenotypes in communitydwelling older adults. Methods: This cross-sectional study included 82 participants (66.8 ± 5.2 years; 81% females). Moderate-to-vigorous physical activity (MVPA) was assessed using accelerometers, and CRF was measured using the distance covered in the 6-min walk test (6MWT). The vascular health markers were as follows: i) arterial function measured as aortic pulse wave velocity (aPWV) estimated using an automatic blood pressure device; and ii) arterial structure measured as the common carotid intima-media thickness (cIMT). Using a combination of normal cIMT and aPWV values, four groups of vascular health phenotypes were created: normal aPWV and cIMT, abnormal aPWV only, abnormal cIMT only, and abnormal aPWV and cIMT. Multiple linear regression was used to estimate the beta coefficients (β) and their respective 95% confidence intervals (95% CI) adjusting for BMI, and medication for diabetes, lipid, and hypertension, sex, age, and blood pressure. Results: Participants with abnormal aPWV and normal cIMT (β = −53.76; 95% CI = −97.73—−9.78 m; p = 0.017), and participants with both abnormal aPWV and cIMT (β = −71.89; 95% CI = −125.46—−18.31 m; p = 0.009) covered less distance in the 6MWT, although adjusting for age, sex and blood pressure decreased the strength of the association with only groups of abnormal aPWV and cIMT covering a lower 6MWT distance compared to participants with both normal aPWV and cIMT (β = −55.68 95% CI = −111.95–0.59; p = 0.052). No associations were observed between MVPA and the vascular health phenotypes. Conslusion: In summary, poor CRF, but not MVPA, is associated with the unhealthiest vascular health phenotype (abnormal aPWV/cIMT) in older adults. [ABSTRACT FROM AUTHOR]

Patients with systemic lupus erythematosus (SLE) are at an increased risk of cardiovascular disease. We aimed to evaluate whether antibodies to oxidized low-density lipoprotein (anti-oxLDL) were associated with subclinical atherosclerosis in patients with different SLE phenotypes (lupus nephritis, antiphospholipid syndrome, and skin and joint involvement). Anti-oxLDL was measured by enzyme-linked immunosorbent assay in 60 patients with SLE, 60 healthy controls (HCs) and 30 subjects with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Intima-media thickness (IMT) assessment of vessel walls and plaque occurrence were recorded using high-frequency ultrasound. In the SLE cohort, anti-oxLDL was again assessed in 57 of the 60 individuals approximately 3 years later. The levels of anti-oxLDL in the SLE group (median 5829 U/mL) were not significantly different from those in the HCs group (median 4568 U/mL), while patients with AAV showed significantly higher levels (median 7817 U/mL). The levels did not differ between the SLE subgroups. A significant correlation was found with IMT in the common femoral artery in the SLE cohort, but no association with plaque occurrence was observed. The levels of anti-oxLDL antibodies in the SLE group were significantly higher at inclusion compared to 3 years later (median 5707 versus 1503 U/mL, p < 0.0001). Overall, we found no convincing support for strong associations between vascular affection and anti-oxLDL antibodies in SLE. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is linked to higher adult mortality and morbidity from atherosclerosis. It is primordial to detect at-risk children earlier-on to prevent disease progression. Carotid intima-media thickness (IMT) is a subclinical radiological marker for early atherosclerosis. B-mode ultrasound is a known technique to assess IMT, but no gold standard technique exists in children. Non-invasive vascular elastography (NIVE) using speckle statistics is an innovative alternative to evaluate IMT and adds by providing translation, strain and shear strain measurements. Validation studies for both techniques lack in children. Purpose: Validate the reproducibility of the 2 techniques in Canadian children. Methods: We conducted a prospective study where anthropometry, blood pressure, IMT and elastography were measured. Six operators obtained 2 measurements for both carotid arteries using both techniques, for a total of 720 measurements. Inter- and intra-class correlation coefficients (ICC) were calculated for each measurement technique and elastography parameters. Results: 30 participants (13.0 ± 1.26 years, 17 girls) were recruited. Twelve were overweight. No significant difference was found in mean IMT between weight groups for either technique (P =.15 and P =.60). We found excellent inter- (ICC =.98 [95% Confidence Interval (CI):.97;.99]) and intra- (ICC =.90-.93) operator reliability for the B-mode technique, and good inter (ICC =.70 [95% CI:.47;.85]) and intra- (ICC =.71-.91) operator reliability for the NIVE-based technique. Poor reliability was found between techniques (ICC =.30 [95% CI: −.31;.65). For elastography parameters, translation was the most reliable (ICC =.94-.95). Conclusion: IMT measurement is reproducible in children but not between techniques. NIVE gives the advantage of evaluating elastography. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the prevalence of carotid intima‐media thickness (IMT) and plaques in a cohort of people living with HIV (PLWH), the role of cardiovascular risk factors, the impact of the antiretroviral regimens and the difference between naïve and experienced patients in the onset of carotid lesions. Methods: This project was initiated in 2019 and involves eight Italian centres. Carotid changes were detected using a power colour‐Doppler ultrasonography with 7.5 MHz probes. The following parameters were evaluated: IMT of both the right and left common and internal carotids, data regarding risk factors for cardiovascular disease, HIV viral load, CD4 cell counts, serum lipids, glycaemia and body mass index. The associations between pathological findings and potential risk factors were evaluated by logistical regression, with odds ratios (ORs) and 95% confidence intervals (95% CI)s. Results: Among 1147 evaluated PLWH, with a mean age of 52 years, 347 (30.2%) had pathological findings (15.8% plaques and 14.5% IMT). Besides the usual risk factors, such as older age, male sex and dyslipidaemia, CD4 cell nadir < 200 cells/mL (adjusted OR = 1.51, 95% CI: 1.14–1.99) and current use of raltegravir (adjusted OR = 1.54, 95% CI: 1.01–2.36) were associated with higher prevalence of pathological findings. Conclusions: Our data show that the current overall percentage of carotid impairments remains high. Colour‐Doppler ultrasonography could play a pivotal role in identifying and quantifying atherosclerotic lesions among PLWH, even at a very premature stage, and should be included in the algorithms of comorbidity management of these patients. [ABSTRACT FROM AUTHOR]

We assessed the correlation between the biomarkers of lower limb atherosclerosis (eg, ankle-brachial index [ABI]) and of carotid atherosclerosis (eg, common carotid intima-media thickness (IMT) and presence of atherosclerotic plaque) in a population-based cohort from Girona (Northwest Spain) recruited in 2010. Ankle-brachial index and carotid ultrasound were performed in all participants. Generalized additive multivariable models were used to adjust a regression model of common carotid IMT on ABI. Logistic regression multivariable models were adjusted to assess the probability of carotid plaque in individuals with peripheral artery disease. We included 3307 individuals (54.2% women), mean age 60 years (standard deviation 11). Two patterns of association were observed between subclinical biomarkers of atherosclerosis at the lower limb and carotid artery. Ankle-brachial index and common carotid IMT showed a linear trend in men [beta coefficient (95% confidence interval) =-.068 (−.123; −.012); P =.016]. Women with peripheral artery disease presented with high risk of atherosclerotic plaque at the carotid artery [Odds ratio (95% confidence interval) = 2.61, (1.46; 4.69); P =.001]. Men showed a significant linear association between ABI levels and common carotid IMT values. Women with peripheral artery disease presented with high risk of atherosclerotic plaque at the carotid artery. [ABSTRACT FROM AUTHOR]

Common carotid intima-media thickness (CIMT) is a common measure of atherosclerosis, often assessed through carotid ultrasound images. However, the use of deep learning methods for medical image analysis, segmentation and CIMT measurement in these images has not been extensively explored. This study aims to evaluate the performance of four recent deep learning models, including a convolutional neural network (CNN), a self-organizing operational neural network (self-ONN), a transformer-based network and a pixel difference convolution-based network, in segmenting the intima-media complex (IMC) using the CUBS dataset, which includes ultrasound images acquired from both sides of the neck of 1088 participants. The results show that the self-ONN model outperforms the conventional CNN-based model, while the pixel difference- and transformer-based models achieve the best segmentation performance. [ABSTRACT FROM AUTHOR]

Purpose: Generalized anxiety disorder (GAD) is a psychiatric condition where both physical and mental symptoms are observed due to the activation of the sympathetic system. It is known that the disorder affects the cardiovascular system. The present study aimed to analyze arterial stiffness in GAD patients and compare the findings with healthy controls. Materials and Methods: 40 patients diagnosed with GAD and 40 healthy individuals were included in the study. Carotid and femoral artery intima-medial thickness (IMT) and arterial thickness parameters were measured with Doppler ultrasonography. Results: The femoral IMT of the patients was significantly low. Although the carotid IMT was higher in patients when compared to the controls, the difference was not statistically significant. A significant negative correlation was determined between fluoxetine equivalent dose and femoral IMT. There was a correlation between femoral IMT and fluoxetine equivalent dose. Conclusion: Arterial stiffness should be investigated for its potential to indicate cardiovascular risk in GAD. Further comprehensive studies should be conducted to clarify whether atherosclerosis symptoms were associated with the nature of the GAD or prescription medicine. [ABSTRACT FROM AUTHOR]

Introduction: Contrast-induced acute kidney injury (CIAKI) is one of the main causes of acute renal failure in hospitalized patients, following the administration of iodinated contrast medium used for CT scans and angiographic procedures. CIAKI determines a high cardiovascular risk and appears to be one of the most feared complications of coronary angiography, causing a notable worsening of the prognosis with high morbidity and mortality. Aim: To evaluate a possible association between the renal resistive index (RRI) and the development of CIAKI, as well as an association with the main subclinical markers of atherosclerosis and the main cardiovascular risk factors. Materials and Methods: We enrolled 101 patients with an indication for coronary angiography. Patients underwent an assessment of renal function (serum nitrogen and basal creatinine, 48 and 72 h after administration of contrast medium), inflammation (C reactive protein (CRP), serum calcium and phosphorus, intact parathormone (iPTH), 25-hydroxyvitaminD (25-OH-VitD), serum uric acid (SUA), total cholesterol, serum triglycerides, serum glucose and insulin). All patients also carried out an evaluation of RRI, intima-media thickness (IMT), interventricular septum (IVS) and the ankle-brachial index (ABI). Results: 101 patients (68 male), with a mean age of 73.0 ± 15.0 years, were enrolled for the study; 35 are affected by type 2 diabetes mellitus. A total of 19 cases of CIAKI were reported (19%), while among diabetic patients we reported an incidence of 23% (8 patients). In our study, patients with CIAKI had significantly higher RRI (p < 0.001) and IMT (p < 0.001) with respect to the patients who did not develop CIAKI. Furthermore, patients with CIAKI had significantly higher CRP (p < 0.001) and SUA (p < 0.006). Conclusions: We showed a significant difference in RRI, IMT, SUA and CRP values between the population developing CIAKI and patients without CIAKI. This data appears relevant considering that RRI and IMT are low-cost, non-invasive and easily reproducible markers of endothelial dysfunction and atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Several personality traits increase the risk for atherosclerotic cardiovascular disease. Because many of these traits are correlated, their associations with disease risk could reflect shared variance, rather than unique contributions of each trait. We examined a higher‐order personality trait of Stability as related to preclinical atherosclerosis and tested whether any such relationship might be explained by correlated variation in cardiometabolic risk factors. Method: Among 798 community volunteers, lower‐order traits of Neuroticism, Agreeableness, and Conscientiousness were modeled as latent variables (from self‐ and informant ratings) and used to estimate the second‐order factor, Stability. Cardiometabolic risk was similarly modeled from indicators of glycemic control, blood pressure, adiposity, and lipids. Carotid artery atherosclerosis was measured as intima‐media thickness (IMT) by duplex ultrasonography. Result: A structural equation model incorporating direct and indirect effects showed lower Stability associated with greater IMT, and this relationship was accounted for by the indirect pathway via cardiometabolic risk. Secondary analyses showed that: (1) Neuroticism, Agreeableness, and Conscientiousness were unrelated to IMT independent of Stability; and (2) Stability predicted variation in IMT when estimated from informant‐, but not self‐rated, traits. Conclusion: Personality traits may associate with atherosclerotic burden through their shared, rather than unique, variance, as reflected in Stability. [ABSTRACT FROM AUTHOR]

To compare carotid intima-media thickness (cIMT), systolic and diastolic diameters (D), intima-media thickness/diameter ratio (IDR) values in children with ASD, and control groups, and to analyze the correlation of these parameters with the Childhood Autism Rating Scale (CARS) scores. This prospective case-control study included 37 children diagnosed with ASD and 38 individuals without ASD in the control group. Correlation assessments of sonographic measurements with CARS scores in the ASD group were also performed. Diastolic diameters of the right (median of ASD group:5.5 mm, control group:5.1 mm) and left (median of ASD group: 5.5 mm, in control group: 5.1 mm) side were higher in the ASD group (p =.015 and p =.032 respectively). A statistically significant correlation was detected between CARS score and left cIMT, right cIMT, right cIMT/systolic D, right cIMT/diastolic D, left cIMT/systolic D, and left cIMT/diastolic D (p <.05). Vascular diameters, cIMT, and IDR values of children with ASD positively correlated with CARS scores, and these findings could be interpreted as a marker of early atherosclerosis in children with ASD. [ABSTRACT FROM AUTHOR]

Background/purpose: A nomenclature of "metabolic associated fatty liver disease" (MAFLD) with a new definition was proposed in 2020 instead of the previous "non-alcoholic fatty liver disease" (NAFLD). Whether it better coheres with the clinical demand remains controversial. Methods: The participants with fatty liver on ultrasonography in Taiwan bio-bank cohorts were included. MAFLD is defined as the presence of fatty liver, plus any of the following three conditions: overweight/obesity, type 2 diabetes mellitus (DM), or metabolic dysfunction. The severity of liver fibrosis was determined using fibrosis-4 (FIB-4) index and NAFLD fibrosis score (NFS). The risk of atherosclerotic cardiovascular disease was assessed using intima–media thickness (IMT) or plaques of carotid duplex ultrasound. Results: A total of 9,719 subjects (ages 55.9 ± 10.8; males 42.6%) were distributed among 4 groups: "overlapping group", "MAFLD only", "NAFLD only", and "neither fatty liver disease (FLD)" with the percentages of 79.7, 12, 7.1, and 1.2%, respectively. Compared with NAFLD patients, MAFLD patients had a greater percentage of males, higher levels of BMI, waist circumference, HbA1c, and triglyceride. In addition, they had higher levels of serum ALT, AST, GGT, fatty liver index (FLI), NFS, and IMT, but no difference in FIB-4 index and the percentage of carotid plaques. To note, "MAFLD only group" had greater levels of AST, ALT, GGT, FLI, FIB-4, NFS, IMT and a higher percentage of carotid plaques than the "NAFLD only group". Conclusion: The grand, population-based study showed MAFLD with new diagnostic criteria to aid in identifying a greater number of high-risk patients of metabolic, liver, and cardiovascular complications, suggesting MAFLD may be a better nomenclature than NAFLD in clinical practice. [ABSTRACT FROM AUTHOR]

Advanced glycation end-products (AGEs) are implicated in vascular aging due to their pro-inflammatory properties. Skin autofluorescence (SAF) is a measure to estimate their deposition. It is an easily quantifiable marker that has been shown to correlate with cardiovascular risk and parameters of metabolic diseases. Herein, we compared skin autofluorescence with other techniques indicating increased cardiovascular diseases, namely, pulse wave velocity (PWVao) and intima–media thickness (IMT). We also studied the impacts of other parameters in deeply phenotyped cohorts of young, middle-aged, and older individuals. SAF, aortic PWVao, and IMT proved to be significantly correlated with each other and with age. However, based on a moderator analysis, we could not show that these associations were affected by age. Some specific parameters such as creatinine and CRP were found to be significantly associated with skin AGE values after adjusting for confounding variables. In conclusion, SAF is a simple screening tool for vascular health with comparable power to more elaborated technical tests. [ABSTRACT FROM AUTHOR]

Background: The association of celiac disease (CD) with premature atherosclerosis, including increased carotid artery intima-media thickness and cardiovascular disease (CVD), is controversial. The aim of this study was to investigate this relationship. Methods: Clinical records of patients from Northern Sardinia referred to the Gastroenterology section of the Department of Medicine, University of Sassari, Italy, were analyzed. Unadjusted and adjusted odds ratios (ORs) for CVD with their 95% confidence intervals (CIs) were calculated according to established risk factors, including age, sex, diabetes, dyslipidemia, overweight/obesity, blood hypertension, and cigarette smoking, as well as a possible risk factor such as H. pylori infection. Results: In a total of 8495 patients (mean age 52.1 ± 17.3 years; 64.7% females), 2504 reported a diagnosis of CVD and 632 of CD. Logistic regression analysis showed a significantly reduced risk of CVD among patients with CD (OR 0.30, 95% CI 0.22–0.41). Moreover, the long duration of the gluten-free diet (GFD) was able to lower the risk of CVD in celiac patients. Finally, CD significantly decreased the frequency of carotid plaques (11.8% vs. 40.1%, p < 0.001). Conclusions. Our retrospective study demonstrated that CD reduces the risk of CVD in general and more specifically of carotid lesions after adjusting for potential confounders, especially in those on GFD for a long time. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the rate of subclinical carotid atherosclerosis and clinical significance of immunoinflammatory markers in patients with rheumatoid arthritis (RA) at low cardiovascular risk. Materials and Methods: The study included 275 RA patients and a control group of 100 participants without autoimmune diseases. All study participants were at low cardiovascular risk, calculated by the QRISK3 scale (<20%), and free of cardiovascular disease. Ultrasound examination of carotid arteries was performed to measure cIMT and to detect atherosclerotic plaques (ASP) in carotid arteries. sIСАМ-1, sVСАМ, and sCD40L levels were determined by enzyme immunoassay. Results: Carotid ASP was observed more frequently in RA patients (27%) than in the control group (17%), p = 0.03. The frequency of ASP in RA patients did not depend on the disease's stage or activity. There was a significant correlation between cIMT and age, cardiovascular risk determined by QRISK3, level of total cholesterol, LDL, and blood pressure in RA patients, p < 0.05 in all cases. No correlation between cIMT and blood levels of sCD40L, sVCAM, and sICAM was found. In RA patients, a higher concentration of sVCAM was detected in the carotid ASP group compared to the non-atherosclerotic group. sCD40L was associated with cIMT and total cholesterol in the ASP group and with total cholesterol and blood pressure in non-atherosclerotic patients. Conclusions: Subclinical atherosclerotic lesions of the carotid arteries were observed significantly more frequently in RA patients with low cardiovascular risk than in the control group. The results of the study demonstrate the association between cIMT, traditional cardiovascular risk factors, and immunoinflammatory markers in RA patients. [ABSTRACT FROM AUTHOR]

Background: Carotid intima-media thickness (IMT) measured in B-mode ultrasound image is an important indicator of Atherosclerosis disease. Speckle noise inherently present in ultrasounds’ thereby degrades the visual evaluation and limits the automated segmentation performance. The objective of this study is to investigate the effects of three despeckle filters on the segmentation of carotid IMT in ultrasound image. Methods: Automated segmentation of IMT is achieved by utilizing fast fuzzy c-mean clustering and distance-regularized level set without re-initialization techniques. Manual segmentation has been done by an experienced radiologist. The performances of median, hybrid median and improved adaptive complex diffusion (IACDF) filters are examined and a quantitative and qualitative comparison among these filters has been reported on 151 DICOM images. Bland–Altman plots were used to compare IMT results of these filters.Furthermore, performances of above three filters are evaluated under different noise levels by individually adding speckle and salt and pepper noise in ten randomly selected images from 151 DICOM dataset. Plots between noise and quality evaluation metric parameters are used to compare de-noising performance of these filters. Results: The average processing time per image of proposed IMT measurement technique without-filter and with filter is approx 15.39 s max. Conclusion: It is shown that the median filter (window 5 × 5) measures better than hybrid median and IACDF filters. Finally, concluded that de-noising of ultrasound image before segmentation procedure certainly improves segmentation accuracy. Furthermore, it is observed that these filters do not impose serious computational burden and entail moderate processing time.

Abstract Background Increased head and neck cancer (HNC) survival requires attention to long-term treatment sequelae. Irradiated HNC survivors have a higher ischemic stroke risk. However, the pathophysiology of radiation-induced vasculopathy is unclear. Arterial stiffness could be a biomarker. This study examined alterations in intima-media thickness (IMT) and stiffness-related parameters, shear wave (SWV) and pulse wave velocity (PWV), in irradiated compared to control carotids in unilateral irradiated patients. Methods Twenty-six patients, median 40.5 years, 5–15 years after unilateral irradiation for head and neck neoplasms underwent a bilateral carotid ultrasound using an Aixplorer system with SL18-5 and SL10-2 probes. IMT, SWV, and PWV were assessed in the proximal, mid, and distal common (CCA) and internal carotid artery (ICA). Plaques were characterized with magnetic resonance imaging. Measurements were compared between irradiated and control sides, and radiation dose effects were explored. Results CCA-IMT was higher in irradiated than control carotids (0.54 [0.50–0.61] vs. 0.50 [0.44–0.54] mm, p = 0.001). For stiffness, only anterior mid-CCA and posterior ICA SWV were significantly higher in the irradiated side. A radiation dose–effect was only (weakly) apparent for PWV (R2: end-systolic = 0.067, begin-systolic = 0.155). Ultrasound measurements had good–excellent intra- and interobserver reproducibility. Plaques had similar characteristics but were more diffuse in the irradiated side. Conclusions Increased CCA-IMT and SWV in some segments were seen in irradiated carotids. These alterations, even in young patients, mark the need for surveillance of radiation-induced vasculopathy. Trial registration: clinicaltrials.gov ( https://clinicaltrials.gov/ct2/show/NCT04257968 ).

[Display omitted] • EWAS using monozygotic twins detected 14 CpGs associated with IMT-Cmax and 21 CpGs associated with mean IMT. • GWAS using monozygotic twins detected seven SNPs associated with IMT-Cmax and one SNP associated with mean IMT. • Identified genetic and epigenetic factors were related to genes involved in metabolic mechanisms, thrombotic formation, and leukocyte dynamics. The intima-media thickness (IMT) of the carotid artery, an indicator of subclinical atherosclerosis, varies in close association with various factors such as diabetes and immune response. The extent of changes in IMT varies among individuals owing to both genetic and epigenetic factors. In this study, we aimed to identify single nucleotide polymorphisms (SNPs) and DNA methylation patterns that affect carotid IMT in monozygotic (MZ) twins. We measured the maximum IMT (IMT-Cmax) and the mean IMT in the common carotid artery wall using ultrasonography in 107 pairs of MZ twins recruited from the Osaka University Twin Registry. The genotyping of SNPs and the measurement of methylation levels were performed using a beads array, and the expression of each gene was determined by RNA sequencing. Linear regression analysis was performed on each of the two groups: one group consisted of twins randomly selected from each pair, and the other group consisted of co-twins. We identified a CpG site (cg02432467) on HS3ST6 as a significant epigenetic factor in both IMT-Cmax and mean IMT analyses. The methylation level at another site (cg07927379) was negatively correlated with LINC01006 expression and IMT-Cmax. Furthermore, there were significant differences in AP2A2 expression and mean IMT among individuals with each genotype of the rs10902263 polymorphism. We identified genetic and epigenetic factors associated with carotid IMT that may be useful for individualized assessments. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of the study was to assess the ultrasound measurements of the brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) and their relationship in glaucoma patients. Methods Thirty-seven patients with glaucoma and thirty-one healthy controls were included in the study. All glaucoma patients and controls underwent ultrasound measurement of FMD of the brachial artery and ultrasound measurement of IMT of the carotid artery. Results The mean values of brachial FMD were significantly lower among the glaucoma compared with controls (16.4 ± 10.6% vs 20.3 ± 8.5%, p = 0.034). No significant difference was found in carotid IMT (1.2 ± 0.4 vs. 1.1 ± 0.4, p = 0.3), and brachial artery diameter at rest (4.7 ± 0.6 vs. 4.9 ± 0.3, p = 0.2) between the glaucoma patients and controls. The significant difference in brachial artery diameter in hyperemia between the glaucoma patients and controls (5.5 ± 0.6 vs. 5.9 ± 0.4 p = 0.002) was found. A negative correlation among brachial FMD and carotid IMT as well as among brachial FMD and brachial artery diameter at rest was found. Conclusions Impaired brachial FMD indicates presence of systemic vascular endothelial dysfunction in glaucoma; glaucoma patients with lower values of the brachial FMD are at increased risk of having thickened carotid IMT.

Cornelia Then,1,2 Chaterina Sujana,2– 4 Christian Herder,5– 7 Holger Then,8 Margit Heier,3,9 Christa Meisinger,10,11 Annette Peters,3,12 Wolfgang Koenig,12– 14 Wolfgang Rathmann,5,15 Haifa Maalmi,5,7 Katrin Ritzel,1 Michael Roden,5– 7 Michael Stumvoll,16 Barbara Thorand,2,3 Jochen Seissler1,2 1Department of Internal Medicine IV, University Hospital of Ludwigs-Maximilians-University Munich, Munich, Germany; 2German Center for Diabetes Research (DZD), Partner Munich-Neuherberg, Munich, Germany; 3Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany; 4Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, Ludwigs-Maximilians-University Munich, Munich, Germany; 5German Center for Diabetes Research (DZD), Munich, Germany; 6Department of Endocrinology and Diabetology, Medical Faculty and University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; 7Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; 8Freie Waldorfschule Augsburg, Augsburg, Germany; 9KORA Study Centre, University Hospital Augsburg, Augsburg, Germany; 10Independent Research Group Clinical Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany; 11Chair of Epidemiology, University Hospital Augsburg, Augsburg, Germany; 12DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany; 13Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; 14German Heart Center Munich, Technical University of Munich, Munich, Germany; 15Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; 16Department of Medicine, University of Leipzig, Leipzig, GermanyCorrespondence: Cornelia Then, Medizinische Klinik und Poliklinik IV - Klinikum der Ludwig-Maximilians-Universität, Ziemssenstraße 1, München, 80336, Germany, Tel +4989440052111, Fax +4989440054956, Email cornelia.then@med.uni-muenchen.deIntroduction: Endothelin-1 and its prohormone C-terminal pro-endothelin-1 (CT-proET-1) have been linked to metabolic alterations, inflammatory responses and cardiovascular events in selected study populations. We analyzed the association of CT-proET-1 with cardiovascular events and mortality, carotid intima-media-thickness as surrogate for early atherosclerotic lesions, biomarkers of subclinical inflammation and adipokines in a population-based study.Methods: The cross-sectional and prospective analyses used data from the KORA F4 study with a median follow-up time of 9.1 (8.8– 9.4) years. Data on CT-proET-1 and mortality were available for 1554 participants, data on the other outcomes in subgroups (n = 596– 1554). The associations were estimated using multivariable linear regression and Cox proportional hazard models adjusted for sex, age, body mass index, estimated glomerular filtration rate, arterial hypertension, diabetes, low-density and high-density lipoprotein cholesterol, current and former smoking and physical activity. The Bonferroni method was used to correct for multiple testing.Results: In the fully adjusted model, CT-proET-1 was associated with cardiovascular (hazard ratio (HR) per standard deviation increase: 1.66; 95% confidence interval (CI): 1.10– 2.51; p = 0.017) and all-cause mortality (HR: 2.03; 95% CI 1.55– 2.67; p < 0.001), but not with cardiovascular events, and was inversely associated with the intima-media thickness (β: − 0.09 ± 0.03; p = 0.001). CT-proET-1 was positively associated with five out of ten biomarkers of subclinical inflammation and with two out of five adipokines after correction for multiple testing. After inclusion of biomarkers of subclinical inflammation in the Cox proportional hazard model, the association of CT-proET-1 with all-cause mortality persisted (p < 0.001).Conclusion: These results emphasize the complexity of endothelin-1 actions and/or indicator functions of CT-proET-1. CT-proET-1 is a risk marker for all-cause mortality, which is likely independent of vascular endothelin-1 actions, cardiovascular disease and inflammation.Keywords: endothelin, CT-proET-1, mortality, cardiovascular events, subclinical inflammation, intima-media thickness

Nga Phi Thi Nguyen,1,2,&ast; Thuc Luong Cong,3,4,&ast; Thi Thanh Hoa Tran,5 Binh Nhu Do,6 Son Tien Nguyen,1,2 Binh Thanh Vu,7,&ast; Lan Ho Thi Nguyen,8 Manh Van Ngo,9 Hoa Trung Dinh,10 Hoang Duong Huy,11 Nghia Xuan Vu,12 Kien Nguyen Trung,13 Duong Ngoc Vu,14 Nghia The Pham,14 Tuan Dinh Le2,15,&ast; 1Department of Endocrinology, Military Hospital 103, Hanoi, Vietnam; 2Department of Rheumatology and Endocrinology, Vietnam Military Medical University, Hanoi, Vietnam; 3Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam; 4Department of Cardiology, Vietnam Military Medical University, Hanoi, Vietnam; 5Emergency Resuscitation Department, National Hospital of Endocrinology, Hanoi, Vietnam; 6Division of Military Science, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 7Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of General Internal Medicine, National Hospital of Endocrinology, Hanoi, Vietnam; 9Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 10Department of Requested Treatment, National Hospital of Endocrinology, Hanoi, Vietnam; 11Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 12Department of Blood Transfusion, 108 Military Central Hospital, Hanoi, Vietnam; 13Department of Science Management, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 14Department of Imaging Diagnosis, Hanoi Medical University, Hanoi, Vietnam; 15Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam&ast;These authors contributed equally to this workCorrespondence: Tuan Dinh Le, Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Tel +84 388166078, Email letuan985@gmail.com Binh Thanh Vu, Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, Vietnam, Tel +84 334588298, Email binhvt@tbump.edu.vnIntroduction: Low albumin levels, high levels of high-sensitivity C-reactive protein (hs-CRP), and high white blood cell count were risk factors for changes in arterial intima-media thickness (IMT). Femoral artery IMT damages were one of the common peripheral artery type 2 diabetes. This study was conducted to determine the association between femoral artery IMT and plasma albumin, hs-CRP levels, and white blood cell count in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Materials and Methods: From January 2015 to May 2020, 306 patients with nT2D were recruited for this cross-sectional descriptive study at Vietnam’s National Endocrinology Hospital. We measured IMT by Doppler ultrasound.Results: There was a statistically significant difference in albumin, hs-CRP levels, hs-CRP-to-albumin ratio, and white blood cell counts between three different IMT groups namely normal IMT, thick IMT, and atherosclerosis (p = 0.003, p = 0.001, p = 0.001 and p = 0.049, respectively). In the multivariate linear regression analysis, white blood cell count, and hs-CRP levels showed a significantly positive correlation to IMT (standardized B and p of 0.17, 0.015 and 0.163, 0.024, respectively), but albumin levels were a significantly negative correlation to IMT (standardized B = – 0.151, p = 0.029). The multivariate logistic regression analysis showed that albumin (OR = 0.79, 95% CI 0.65– 0.90, p = 0.018), hs-CRP (OR = 1.09, 95% CI 1.01– 1.18, p = 0.026), and white blood cell count (OR = 1.36, 95% CI 1.03– 1.81, p = 0.033) had correlation to atherosclerosis of femoral artery.Conclusion: Reduced plasma albumin, elevated hs-CRP, and white blood cell count associated with IMT increased the odds for atherosclerosis of femoral artery among nT2D.Keywords: plasma albumin, high-sensitivity C-reactive protein, white blood cell count, newly diagnosed type 2 diabetes mellitus, intima-media thickness, atherosclerotic plaque, femoral artery

Objective: We investigated the associations between physical activity (PA) and cardiorespiratory fitness (CRF) with vascular health phenotypes in community-dwelling older adults.Methods: This cross-sectional study included 82 participants (66.8 ± 5.2 years; 81% females). Moderate-to-vigorous physical activity (MVPA) was assessed using accelerometers, and CRF was measured using the distance covered in the 6-min walk test (6MWT). The vascular health markers were as follows: i) arterial function measured as aortic pulse wave velocity (aPWV) estimated using an automatic blood pressure device; and ii) arterial structure measured as the common carotid intima-media thickness (cIMT). Using a combination of normal cIMT and aPWV values, four groups of vascular health phenotypes were created: normal aPWV and cIMT, abnormal aPWV only, abnormal cIMT only, and abnormal aPWV and cIMT. Multiple linear regression was used to estimate the beta coefficients (β) and their respective 95% confidence intervals (95% CI) adjusting for BMI, and medication for diabetes, lipid, and hypertension, sex, age, and blood pressure.Results: Participants with abnormal aPWV and normal cIMT (β = −53.76; 95% CI = −97.73—−9.78 m; p = 0.017), and participants with both abnormal aPWV and cIMT (β = −71.89; 95% CI = −125.46—−18.31 m; p = 0.009) covered less distance in the 6MWT, although adjusting for age, sex and blood pressure decreased the strength of the association with only groups of abnormal aPWV and cIMT covering a lower 6MWT distance compared to participants with both normal aPWV and cIMT (β = −55.68 95% CI = −111.95–0.59; p = 0.052). No associations were observed between MVPA and the vascular health phenotypes.Conslusion: In summary, poor CRF, but not MVPA, is associated with the unhealthiest vascular health phenotype (abnormal aPWV/cIMT) in older adults.

ObjectiveAmong people with HIV, there are few long-term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus.DesignNested cohort study.MethodsParticipants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT > 1.5 mm) at six locations; and Young's modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors.ResultsAmong 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 person-years, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality.ConclusionCarotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.

Introduction: The mechanisms subtending the increased stroke risk in migraine with aura (MA) are not fully understood. Our study aims to evaluate if the clinical profile in stroke patients with MA differentiates from those without MA. Methods: We retrieved the prospective registered electronic clinical dossiers of adult patients younger than 60 years with acute ischemic stroke admitted in four hospitals between January 2016 and June 2022. Patients were classified by the history of MA (MA+ and MA-). Results: We identified 851 stroke patients (59 MA+, 6.9%). Compared to MA-, MA+ patients were characterized by younger age (44.0 ± 10.6 vs 50.1 ± 8.2 years), female sex (59.3% vs 29.0%), and affected by cryptogenic (OR 2.594 95% CI 1.483-4.537), and cerebellar stroke (OR 3.218 95% CI 1.657-6.250; p ≤ 0.001 for all comparisons). After adjusting for age and sex, MA+ patients presented less frequently hypertension (OR 0.349 95% CI 0.167-0.470; p=0.005) and dyslipidemia (OR 0.523 95% CI 0.280-0.974; p = 0.041). After adjusting also for risk factors, the MA+ group had less frequently symptomatic large vessel stenosis (OR 0.126 95% CI 0.017-0,924; p = 0.042) and clinical atherosclerosis (OR 0.103 95% CI 0.014-0.761; p = 0.026), while intima-media thickness did not differ (p = 0.395). Discussion: Cryptogenic and cerebellar stroke and fewer vascular risk factors and clinical atherosclerosis seem to characterize stroke patients with MA. [ABSTRACT FROM AUTHOR]