Search

Context Previous research evaluating the effects in B-vitamins on the prevention and treatment of cardiovascular disease (CVD) has substantial limitations and lacks recently published large prospective studies; hence, conducting an updated meta-analysis is needed. Objective We investigated the association between vitamin B status and human CVD development in order to provide more specific advice about vitamin B intake for those at risk of CVD. Data Sources Relevant articles were identified by JSTOR, PubMed, and ProQuest databases. Data Extraction Key words used to identify the studies included the different combinations of B-vitamins, folate, folic acid, vitamin B6, vitamin B12, homocysteine, cardiovascular disease, stroke, coronary disease, myocardial infarction, and cerebrovascular and transient ischemic attack. The database search was supplemented by hand-searching of reference lists of selected articles. Data Analysis Pooled estimates were calculated from the mean differences using a random-effects model. Results Supplementation with folic acid was reported to have a clinical benefit of significantly reducing carotid intima-media thickness. Higher intakes of folic acid, vitamin B6, and vitamin B12 were generally associated with a lower risk of CVD in the general population, except in those without normal renal function and those with unstable angina or past non–ST-elevation myocardial infarction. Conclusion Vitamin B supplementation resulted in the greatest cardiovascular benefit in those with normal renal function and without unstable angina or non–ST-elevation myocardial infarction recently. Factors such as age, gender, and genetic polymorphisms contribute to varying effects. [ABSTRACT FROM AUTHOR]

Objective: Cardiovascular diseases are the main causes of mortality in the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients. Carotid intima-media thickness (CIMT) measurement and pulse wave velocity (PWV) were performed to determine atherosclerosis and arterial stiffness as cardiovascular risk markers. Patients and Methods: The data of 31 patients with AAV were compared with 21 healthy controls. Demographic and laboratory findings were recorded. Results: Seventeen patients (54.8%) were male. Mean age was 52.6±11.5 years. CIMT was higher in the patient group [0.74 (0.65 -- 0.84) vs 0.63 (0.57-0.74) mm; p=0.048]. PWV [7.9 (6.7-9.3) vs 7.8 (6.8-8.5) m/s; p=0.295] and augmentation index (AI) [22.5 (11.0-30.0) vs. 23 (9.5-30.5) mm/Hg, p=0.801] were similar in both groups. CIMT was correlated with age (r: 0.538, p<0.001) and PWV (r: 0.554 p< 0.001) while there was no correlation with AI (r: 0.047, p= 0.764). Conclusion: The present study showed that CIMT is significantly increased and correlated with age and PWV in patients with AAV compared to controls. CIMT can be used as a screening tool as part of patient follow-up to identify patients at cardiac risk. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate cardiovascular risks and influencing factors by measuring aortic elasticity parameters and carotid intima thickness in children with cronic kidney disease (CKD), and also evaluated the hydration status of patients with bioimpedance spectroscopy (BIS) measurements and investigated the effect of hydration status on vascular functions. Patients and Methods: The study group included an average of 13.3 ± 3.7 years (16 girls and 22 boys, 38 CKD patients), control group on average 12.1 ± 2.9 (16 girls and 15 boys, 31 healthy children). Systolic and diastolic diameters of the aortic annulus and aorta at each level were obtained; z-scores, aortic strain, distensibility, stiffness index were calculated. Carotid intima-media thickness and flow -- mediated dilatation were studied. Bioimpedance spectroscopy was performed to all patients. Results: Interventricular septum and left atrial (p=0.002, p=0.013), sinus valsalva and sinotubular junction z scores (p=0.009, p=0.012) were found to be higher and distensibility and strain decreased, stiffness index increased in the abdominal aorta of patients with CKD (p=0.007, p=0.002, p=0.004). Patients with CKD had statistically significant over-hydration. Conclusion: Vascular wall changes that affect the elastic properties of the aortic wall begin to develop in childhood in patients with CKD. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to evaluate the relationship between carotid intima‐media thickness (CIMT), which is a known indicator of cardiovascular risk and atherosclerosis, and uric acid level, which may be an easy marker for cardiovascular diseases due to its antioxidant and pro‐oxidant properties in hemodialysis patients. Methods: In this cross‐sectional study, we evaluated 77 hemodialysis patients. The mean CIMT of these patients was measured and recorded by Doppler ultrasonography. Patients were divided into two groups according to their serum uric acid levels. Correlation analysis and linear regression analysis were used to define the relationship between study parameters. Findings: The mean CIMT levels in the normouricemic group and the hyperuricemic group were 0.95 ± 0.15 and 1.07 ± 0.15, respectively. There was a statistically significant difference between the two groups (p = 0.001). There was a statistically significant and moderate linear correlation between serum uric acid level and mean CIMT (r = 0.402; p = 0.002). Univariate and multivariate linear regression analyses were performed to identify variables that could independently affect the mean CIMT value. According to analysis, uric acid (p < 0.001), hypertension (p = 0.008), albumin (p = 0.029), and C‐reactive protein (p = 0.042) were found independent risk factors for mean CIMT value. Discussion: We found a significant relationship between serum uric acid level and CIMT, which indicates carotid atherosclerosis. Serum uric acid level is a low‐cost laboratory parameter that can be measured in almost all laboratories, and it may be valuable in the hemodialysis patient group to identify patients at high risk of carotid atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Primary hypertension (HT) has a high mortality rate due to its atherosclerotic complications. Vitamin D (VD) deficiency has been reported to increase the development of non-dipper HT (ND-HT) and atherosclerosis, but there are also conflicting results. To our knowledge, there is no study investigating the relationship between VD and carotid artery intima-media thickness (C-IMT) in patients with HT. Therefore, we aimed to investigate the relationship between VD levels, ND-HT development, and C-IMT in patients with HT with no known cardiovascular disease (CVD). Methods: This study was conducted in 60 (63% female) patients with HT. Ambulatory blood pressure monitoring was performed using a portable digital recording device. C-IMT was measured using B-mode ultrasonography. Vitamin D levels were measured using elect roche milum inesc ence immunoassay. Those with C-IMT =0.750 mm were assumed to have subclinical atherosclerosis, and serum 25-(OH) D3 (VD) levels <20 ng/mL were VD deficient. Results: There was a significant negative linear relationship between VD levels and triglycerides (TG) and smoking, and a significant positive linear relationship between high-density lipoprotein cholesterol levels. Triglyceride levels were significantly (P = .015) higher in patients who were VD deficient compared to those who were VD sufficient. Patients with subclinical atherosclerosis were older (P = .002) than those without. Only patient age was positively associated with C-IMT (P < .001). There was no relationship between VD levels/VD deficiency and the presence of ND-HT and subclinical atherosclerosis. Conclusion: Our findings suggest that VD deficiency does not facilitate the development of ND-HT and subclinical atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: To investigate the diagnostic value of head and neck computed tomography angiography (CTA) in combination with color Doppler ultrasonography (CDUS) in carotid artery stenosis in ischemic stroke (IS) patients. Materials and Methods: DSA examination was performed on all patients, and they were separated into mild group, moderate group, as well as severe group (n=30) according to the degree of vascular stenosis. Head and neck CTA and CDUS were used to examine the plaque length, thickness, and quantity of each group. The total plaque area, carotid intima-media thickness (IMT), common carotid artery index (CCA), internal carotid artery index (ICA) as well as vertebral artery index (VA) were compared. Results: A total of 110 narrow blood vessels were detected by CTA combined with ultrasound, and had a higher accuracy rate. The total plaque area, length, thickness and number of plaques, the values of CCA, ICA and VA, and IMT in the moderate together with severe groups presented higher relative to the mild group, and those in severe group presented elevated relative to the moderate group (P < 0.05). The sensitivity, specificity and accuracy of the combined detection of head and neck CTA and CDUS in the diagnosis of vascular stenosis in IS patients were higher relative to the single detection (P < 0.05). Conclusion: Head and neck CT angiography in combination with CDUS has a high application value in detecting carotid artery stenosis in IS patients, and provides an important reference value for the formulation of the next treatment plan and the assessment of patient prognosis. [ABSTRACT FROM AUTHOR]

Background: Transgender men use exogenous androgen for male pattern virilization. Hysterectomy and bilateral salpingo-oophorectomy (HBSO) is performed to stop the endogenous estrogen secretion. Cardiovascular disease (CVD) risk has been shown to increase with long-term use of androgens and the removal of estrogen. We aimed to investigate the CVD risk in these individuals by measuring internal and common carotid artery intima–media thicknesses (CIMT). Methods: In this cohort study, data were collected from transgender men who had undergone HBSO and used androgens for at least two years (median treatment duration was 5 years in our research). Cisgender women in the same age range were selected as the control group. Demographics, vital signs, and hematological values of transgender patients and cisgender women subjects in the control group were noted. CVD markers were compared with sonographically measured CIMT values. Results: The mean age and body mass index (BMI) of the study group were 32.6 and 25.3, respectively. Weight, systolic–diastolic blood pressure, hemoglobin, hematocrit, low-density lipoprotein (LDL), serum triglyceride (TG), HbA1c levels, internal CIMT, and common CIMT values of the study group were higher, while the high-density lipoprotein (HDL) level was significantly lower compared the control group (p1 = 0.025, p2 = 0.010, p3 = 0.002, p4 = 0.001, p5 = 0.001, p6 = 0.012, p7 = 0.008, p8 = 0.007, p9 = 0.013, and p10 = 0.001). There was also an increase in the body weight, BMI, LDL, and TG levels of the study group after the testosterone treatment (p1 = 0.025, p2 = 0.019, p3 = 0.001, p4 = 0.001, and p5 = 0.001). Conclusions: We demonstrated that the use of testosterone therapy in transgender men is associated with higher CIMT values. While further investigation is needed to assess morbidity and mortality rates, we recommend that regular clinical and radiological examinations be performed in these individuals to accurately evaluate the risk of CVD. [ABSTRACT FROM AUTHOR]

Background: Coronary artery calcium score (CACS) and carotid intima-media thickness (CIMT) are important markers for early detection of coronary atherosclerosis. The study aimed to investigate the relationship between the CIMT and the CACS as markers for atherosclerotic coronary artery disease (CAD). Methods: This single-center prospective study enrolled 41 cases with suspected CAD. The cases underwent carotid artery US and CA noncontrast CT (NCCT). A radiologist with eight years of experience in vascular US imaging performed the carotid artery US, while two radiologists with ten years of experience in cardiac imaging analyzed the coronary artery CT images and assigned a CAC-DRS category for each case. We used the Pearson correlation test to calculate the correlation between CIMT and CACS. The receiver operating characteristics (ROC) curve was used to estimate the best cutoff value of CIMT in predicting CA heavy calcification. Results: The study included 41 cases of suspected CAD, of which 12-showed heavy, and 29 showed non-heavy CA calcification. The mean CACS was 163, and the highest CIMT was 0.785 mm among the included patients. There was a significant positive correlation between the CACS and the highest CIMT (r 0.606 and P <0.001). A CIMT > 0.8 mm was the best cutoff for predicting heavy calcification, with a sensitivity of 91.7%, a specificity of 65.5%, and an accuracy of 73.2% based on ROC curve analysis. Conclusions: CIMT and CACS can be considered non-invasive predictive measures for CA atherosclerosis and subsequent CAD. Moreover, these markers might help cardiologists in clinical management. [ABSTRACT FROM AUTHOR]

Background: Vessel‐wall volume and localized three‐dimensional ultrasound (3DUS) metrics are sensitive to the change of carotid atherosclerosis in response to medical/dietary interventions. Manual segmentation of the media‐adventitia boundary (MAB) and lumen‐intima boundary (LIB) required to obtain these metrics is time‐consuming and prone to observer variability. Although supervised deep‐learning segmentation models have been proposed, training of these models requires a sizeable manually segmented training set, making larger clinical studies prohibitive. Purpose: We aim to develop a method to optimize pre‐trained segmentation models without requiring manual segmentation to supervise the fine‐tuning process. Methods: We developed an adversarial framework called the unsupervised shape‐and‐texture generative adversarial network (USTGAN) to fine‐tune a convolutional neural network (CNN) pre‐trained on a source dataset for accurate segmentation of a target dataset. The network integrates a novel texture‐based discriminator with a shape‐based discriminator, which together provide feedback for the CNN to segment the target images in a similar way as the source images. The texture‐based discriminator increases the accuracy of the CNN in locating the artery, thereby lowering the number of failed segmentations. Failed segmentation was further reduced by a self‐checking mechanism to flag longitudinal discontinuity of the artery and by self‐correction strategies involving surface interpolation followed by a case‐specific tuning of the CNN. The U‐Net was pre‐trained by the source dataset involving 224 3DUS volumes with 136, 44, and 44 volumes in the training, validation and testing sets. The training of USTGAN involved the same training group of 136 volumes in the source dataset and 533 volumes in the target dataset. No segmented boundaries for the target cohort were available for training USTGAN. The validation and testing of USTGAN involved 118 and 104 volumes from the target cohort, respectively. The segmentation accuracy was quantified by Dice Similarity Coefficient (DSC), and incorrect localization rate (ILR). Tukey's Honestly Significant Difference multiple comparison test was employed to quantify the difference of DSCs between models and settings, where p≤0.05$p\,\le \,0.05$ was considered statistically significant. Results: USTGAN attained a DSC of 85.7±13.0$85.7\,\pm \,13.0$% in LIB and 86.2±10.6${86.2}\,\pm \,{10.6}$% in MAB, improving from the baseline performance of 74.6±30.7${74.6}\,\pm \,{30.7}$% in LIB (p<10−12$<10^{-12}$) and 75.7±28.9${75.7}\,\pm \,{28.9}$% in MAB (p<10−12$<10^{-12}$). Our approach outperformed six state‐of‐the‐art domain‐adaptation models (MAB: p≤3.63×10−7$p \le 3.63\,\times \,10^{-7}$, LIB: p≤9.34×10−8$p\,\le \,9.34\,\times \,10^{-8}$). The proposed USTGAN also had the lowest ILR among the methods compared (LIB: 2.5%, MAB: 1.7%). Conclusion: Our framework improves segmentation generalizability, thereby facilitating efficient carotid disease monitoring in multicenter trials and in clinics with less expertise in 3DUS imaging. [ABSTRACT FROM AUTHOR]

While carotid intima-media thickness (cIMT) as a noninvasive surrogate measure of atherosclerosis is widely considered a risk factor for stroke, the intrinsic link underlying cIMT and stroke has not been fully understood. We aimed to evaluate the clinical value of cIMT in stroke through the investigation of phenotypic and genetic relationships between cIMT and stroke. We evaluated phenotypic associations using observational data from UK Biobank (N = 21,526). We then investigated genetic relationships leveraging genomic data conducted in predominantly European ancestry for cIMT (N = 45,185) and any stroke (AS, Ncase/Ncontrol=40,585/406,111). Observational analyses suggested an increased hazard of stroke per one standard deviation increase in cIMT (cIMTmax-AS: hazard ratio (HR) = 1.39, 95%CI = 1.09–1.79; cIMTmean-AS: HR = 1.39, 95%CI = 1.09–1.78; cIMTmin-AS: HR = 1.32, 95%CI = 1.04–1.68). A positive global genetic correlation was observed (cIMTmax-AS: =0.23, P=9.44 × 10−5; cIMTmean-AS: =0.21, P=3.00 × 10−4; cIMTmin-AS: =0.16, P=6.30 × 10−3). This was further substantiated by five shared independent loci and 15 shared expression-trait associations. Mendelian randomization analyses suggested no causal effect of cIMT on stroke (cIMTmax-AS: odds ratio (OR)=1.12, 95%CI=0.97–1.28; cIMTmean-AS: OR=1.09, 95%CI=0.93–1.26; cIMTmin-AS: OR=1.03, 95%CI = 0.90–1.17). A putative association was observed for genetically predicted stroke on cIMT (AS-cIMTmax: beta=0.07, 95%CI = 0.01–0.13; AS-cIMTmean: beta=0.08, 95%CI = 0.01–0.15; AS-cIMTmin: beta = 0.08, 95%CI = 0.01–0.16) in the reverse direction MR, which attenuated to non-significant in sensitivity analysis. Our work does not find evidence supporting causal associations between cIMT and stroke. The pronounced cIMT-stroke association is intrinsic, and mostly attributed to shared genetic components. The clinical value of cIMT as a surrogate marker for stroke risk in the general population is likely limited. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency is a common cause of secondary hyperparathyroidism, particularly in elderly people. The aim of this study was to evaluate the associations of serum vitamin D and parathormone (PTH) concentrations with blood pressure values and hypertension-mediated target organ damage (HMOD), including left ventricular (LV) hypertrophy and carotid plaque (CP). We enrolled consecutive patients admitted to the Hypertension Center of Federico II University Hospital in Naples, Italy. All patients underwent carotid doppler ultrasound and echocardiography, measurement of vitamin D and PTH levels and main clinical and laboratory parameters. A total of 126 patients (mean age 54 years, 68% males) were enrolled. Pearson's correlation analysis indicated that PTH levels directly correlated with age, diabetes, dyslipidemia, hypertension, fasting glucose, and LV mass, and inversely with glomerular filtration rate, LDL cholesterol, and vitamin D. Vitamin D levels correlated inversely with PTH, diabetes and CP. Multivariate regression models indicated that an increased LV mass was associated with the presence of obesity (β = 0.342; P = 0.001). Maximal intima-media thickness was significantly associated with older age (β = 0.303; P = 0.033). Combined presence of low vitamin D/high PTH levels were associated with more than 4-fold increased risk of having CP in both univariate (OR = 4.77, p = 0.0001) and multivariate regression analysis (OR = 4.52, p = 0.014). In a population at high cardiovascular risk, vitamin D and PTH levels were not directly associated with blood pressure values and HMOD. Secondary hyperparathyroidism due to vitamin D deficiency is associated with carotid atherosclerosis independently of other common cardiovascular risk factors. • Vitamin D deficiency and Parathormone (PTH) excess are common findings in general population. • PTH affects glucose metabolism and PTH level was associated with higher fasting glucose. • Vitamin D and PTH are not directly associated with hypertension and related target organ damage. • Secondary hyperparathyroidism due to vitamin D deficiency is associate with carotid atherosclerosis. [ABSTRACT FROM AUTHOR]

Introduction: Morbidity related to cardiovascular disease (CVD) is a leading epidemiological problem. Carotid intima-media thickness (CIMT) can be regarded as a surrogate marker for cardiovascular disease. Lipid-lowering agents such as statins have proven to reduce future risk and promote regression of atherosclerotic plaques. Aim: To relate long-term high-dose statin therapy to CIMT in a retrospective analysis of patients presenting with preserved ejection fraction heart failure (HFpEF). Material and methods: There were 77 (47 female and 30 male) consecutive patients with a median age of 69 (62–75) years admitted to the Hypertension and Internal Medicine Department presenting with preserved ejection fraction heart failure symptoms in NYHA class 2.0 (0.5) for clinical evaluation in 2024. Laboratory tests, echocardiography, carotid ultrasound, and cine angiography were performed. The possible relation between CIMT and patients' characteristics was evaluated. Results: The multivariable model indicated possible relations between CIMT above 0.8 mm and obesity (BMI > 30 kg/m2) (OR = 11.86, 95% CI: 2.5–54.02, p = 0.001), and high-statin therapy (OR = 0.18, 95% CI: 0.04–0.08, p = 0.024). The receiver operator curve (ROC) was characterized by an area under the curve (AUC) of 0.794 with an F-measure of 0.417, yielding a sensitivity of 35.7% and specificity of 91.8%. Conclusions: The results from the retrospective single-measurement analysis on long-term statin therapy may indicate the relation between CIMT and rosuvastatin (at least 20 mg/day) or atorvastatin (at least 40 mg/day) administration. Long-term statin therapy is associated with a reduced likelihood of having CIMT above 0.8 mm, although the presented results are statin-type and dosage-dependent. [ABSTRACT FROM AUTHOR]

Purpose: Restless legs syndrome is claimed to be associated with a higher risk of cardiovascular diseases. Intimamedia 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. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to extract carotid wall vibrations non-invasively and evaluate changes in the carotid artery caused by age, BMI, and sex. Such evaluation can increase the possibility of detecting wall stiffness and atherosclerosis in the early stages and prevent heart attack and death. Materials and Methods: To extract small vibrations of the carotid wall, the image-tracking method, and optical flow with four different methods were used. The study involved twenty participants, comprising six females and fourteen males, with a mean age of 36.25 years, mean weight of 75.2 Kg, and mean BMI of 25. The posterior wall motion and vibration were extracted using ultrasound RF signals. Results: 4 optical flow methods, Gunnar-Farneback, Horn-Schunk, Lucas-Kanade, and Lucas-Kanade derivative were used for all samples, and covariance, correlation, P-value, and R-squared were estimated. Results showed the differences in parameters such as age and BMI with carotid wall vibration. These values for age are (Cov = -0.1891, Corr = -0.6770, P-value < 0.001, r2 = -0.4590) and for BMI are (Cov = -0.0564, Corr = -0.6510, P-value < 0.001, r2 = 0.4238), respectively. For gender as a new parameter, a comparison between men's and women's vibrations was estimated. The range of measured vibrations by optical flow methods is about 0.0002 µm to 0.1µm, and the mean standard deviation is 0.04967 µm. Conclusion: The results presented that gender affects the vibration of the vessel wall, which in men is more than in women. In addition, increasing age and BMI may increase the stiffness of the carotid wall and reduce vibrations that were evaluated previously. Using the Gunner-Farneback method as image tracking for small vibrations is the best way with the highest accuracy. [ABSTRACT FROM AUTHOR]

Background and objectives: Metabolic-associated fatty liver disease (MAFLD) may increase the risk of cardiovascular events. In this study, we assessed the predictive value of pentraxin 3 (PTX3) for severe fibrosis and carotid intima-media thickness (CIMT) in patients with MAFLD. Methods: 188 patients (114 with MAFLD, 74 with dual etiology MAFLD and chronic hepatitis C) were included. All participants underwent clinical history and examination, metabolic parameter assessment, serum level evaluation of PTX3, Fibrosis-4 index and nafld fibrosis score scores, abdominal ultrasound, and CIMT assessment. Results: The serum PTX3 was significantly elevated in patients with advanced fibrosis compared to those with mild/moderate fibrosis (1.8 vs 1.4, p = 0.006). The PTX3 level was independently associated with advanced fibrosis (odds ratio = 1.26, 95% confidence interval 1.008-1.040). In MAFLD patients, the PTX3 levels in patients with low fibrosis compared to those with advanced fibrosis were 1.4 (1-2.1) and 1.9 (1.3-3.8), respectively (p = 0.027). A significantly greater CIMT was noted in patients with elevated PTX3 levels (3.85 (3.42-4) vs 4.05 (3.7-4.67), p = 0.0001) compared to those with low PTX3 levels. Conclusions: Serum PTX3 levels can accurately predict advanced fibrosis and CIMT in MAFLD patients. Thus, it could be useful for management and risk stratification. [ABSTRACT FROM AUTHOR]

Objective: To assess the clinical utility of ultrasound in predicting the risk of carotid vulnerable plaque rupture using pathological intraplaque hemorrhage as the gold standard. Methods: A total of 118 patients who underwent endarterectomy due to symptomatic carotid artery stenosis were enrolled. Conventional ultrasound assessed the plaque thickness, area stenosis rate, echo, and surface morphology. Neovascularization were assessed by contrast‐enhanced ultrasound (CEUS) and tracing intraplaque nonenhanced areas. According to neovascularization grade (0–4), plaques were classified as low‐, intermediate‐, and high risk. Fresh intraplaque hemorrhage within the pathology was adopted as the gold standard for diagnosing plaque rupture risk. Thus, we divided patients into ruptured risk and nonruptured risk groups to assess the value of crucial factors for plaque rupture risk using ultrasound. Results: Of the 118 patients, hypertension accounted for 71.2%, hyperlipidemia 68.6%, diabetes 52.5%, and statin history 64.4%. In the rupture risk group, diabetes, smoking, and stenosis rate were significantly higher than the nonrupture risk group (P <.001); plaque thickness ≥4 mm (P >.05); and mainly hypoechoic with irregular surface morphology (P <.001), nonenhanced areas in the plaques (P <.001), and neovascularization >grade 2 (P <.001). Compared with the low‐risk group, plaque rupture risk was 7.219 times higher in the medium‐risk group and 18.333 times higher in the high‐risk group. The kappa value of the interobserver consistency of crucial ultrasound parameters was >0.75, and the intraclass correlation coefficient was 0.919 (P <.01). Conclusions: Both conventional ultrasound and CEUS have significant clinical importance in the prediction of rupture risk in vulnerable carotid plaques, thereby enabling stroke risk stratification and the assessment of plaque rupture risk. [ABSTRACT FROM AUTHOR]

BACKGROUND: Individuals with type 2 diabetes (T2D) have an increased risk of coronary artery disease (CAD), but questions remain about the underlying pathology. Identifying which CAD loci are modified by T2D in the development of subclinical atherosclerosis (coronary artery calcification [CAC], carotid intima-media thickness, or carotid plaque) may improve our understanding of the mechanisms leading to the increased CAD in T2D. METHODS: We compared the common and rare variant associations of known CAD loci from the literature on CAC, carotid intima-media thickness, and carotid plaque in up to 29 670 participants, including up to 24 157 normoglycemic controls and 5513 T2D cases leveraging whole-genome sequencing data from the Trans-Omics for Precision Medicine program. We included first-order T2D interaction terms in each model to determine whether CAD loci were modified by T2D. The genetic main and interaction effects were assessed using a joint test to determine whether a CAD variant, or gene-based rare variant set, was associated with the respective subclinical atherosclerosis measures and then further determined whether these loci had a significant interaction test. RESULTS: Using a Bonferroni-corrected significance threshold of P

AimTo investigate the effect of periodontal therapy on endothelial function of subjects with periodontitis in stages III or IV and established cardiovascular disease.Materials and methodsA triple-blinded, parallel groups, randomized clinical trial of 6 months duration, on patients with history of coronary heart disease and periodontitis in stages III or IV was performed. Intervention consisted of steps 1 (oral hygiene instructions and professional mechanical plaque removal) and 2 (subgingival instrumentation) of periodontal therapy, including an antiseptic mouth rinse for 7 days. Patients in the control group received only step 1, with the adjunctive use of a fluoride-containing mouth rinse. Endothelial function (flow-mediated dilation [FMD]) and carotid intima-media thickness (cIMT) at baseline, 3 and 6 months, and serum markers of inflammation and cell adhesion at 3 days, 10 days, 3 and 6 months after therapy, were evaluated. Demographic characteristics, cardiovascular risk factors, history of cardiovascular diseases, medication intake, lipids profile, blood pressure, and periodontal outcomes were also evaluated. Student T, Mann–Whitney U, Chi-square and Fisher-exact tests were performed along with repeated measures ANOVA with post hoc Bonferroni's corrections.ResultsThirty-five patients were included. In the test group, improvements in pocket depth, bleeding on probing and suppuration at 6 months were significantly better than in control patients. Reductions in mean FMD [test group −3.43%; 95% confidence interval—CI [−2.68; 9.54], p = 0.487; control group −6.75%; 95% CI [1.29; 12.22], p = 0.012] and cIMT (test group −0.05 mm; 95% CI [0.01; 0.10], p = 0.014; control group −0.01 mm; 95% CI [−0.03; 0.05], p = 1.000) were observed in both groups from baseline to 6 months, without significant intergroup differences at any time-point. Differences between groups in serum inflammatory markers were detected at baseline and 3 days for interleukin (IL)-18, and at 10 days for IL-8.ConclusionPreliminary results from the present pilot study showed that steps 1 and 2 of periodontal treatment in subjects with periodontitis in stages III–IV and established cardiovascular disease induced improvements in cIMT and periodontal outcomes, although changes in FMD were not observed. Clinical Trial Registrationclinicaltrials.gov, Identifier, database (NCT02716259).

ObjectiveType 2 diabetes mellitus (T2DM) is a major cause of atherosclerosis, as well as an independent risk factor of cardiovascular adverse events. We aimed to evaluate the association of serum Meteorin-like protein (Metrnl) level with carotid atherosclerosis as determined by carotid intima-media thickness (CIMT) status in subjects with T2DM.MethodsThis cross-sectional study included 83 T2DM subjects without pre-existing cardiovascular diseases. CIMT was measured by color doppler ultrasonography, while serum Metrnl level was measured by Enzyme-linked Immunosorbent Assay (ELISA) assay. According to the CIMT status, the subjects were divided into two groups: T2DM without atherosclerosis (DM-AS, CIMT

Background and purposeThe hemoglobin levels in the peripheral blood of individuals living at high altitudes are significantly higher than normal levels. These levels are closely associated with atherosclerosis and cardiovascular events. This study aimed to investigate the correlation between hemoglobin levels in the peripheral blood and hypertension in high-altitude regions, providing a basis for preventing and treating primary hypertension in these regions.Materials and methodsFrom May 2020 to May 2021, patients diagnosed with primary hypertension in plateau regions of China were selected as participants. The clinical data, including lifestyle habits and blood biochemical indicators, were collected from the clinical case database for patients meeting the inclusion criteria. The logistic regression analysis was performed to identify factors influencing carotid intima–media thickness in patients with primary hypertension in plateau regions. The ROC curve was plotted to analyze the impact of peripheral blood hemoglobin levels on hypertension, determine the hemoglobin threshold for predicting hypertension in plateau areas, and evaluate the predictive value of hemoglobin level for hypertension.ResultsA total of 200 patients (105 men with an average age of 64.8 ± 12.75 years and 95 women with an average age of 69.5 ± 11.54 years) were enrolled in this study. Logistic regression analysis revealed that age, CO2-CP, ALT, APOB, CRP, and HGB were independent risk factors for increased carotid artery intima–media thickness (P

The article discusses the relationship between the Mediterranean diet, neutrophil count, and atherosclerosis, highlighting the potential benefits of the Mediterranean diet in reducing cardiovascular risk factors. Studies have shown that adherence to the Mediterranean diet can lead to a decrease in neutrophil counts and regression of atherosclerosis over time. The research emphasizes the importance of diet in cardiovascular health and suggests that reducing neutrophil levels through dietary interventions could be a promising strategy for preventing atherosclerosis. Further studies are needed to explore these associations in diverse populations and to fully understand the impact of dietary interventions on cardiovascular disease. [Extracted from the article]

The article published in BMC Nephrology discusses the relationship between carotid intima-media thickness (CIMT), fibroblast growth factor 23 (FGF23), and mineral bone disorder (MBD) in children with chronic kidney disease (CKD). The study found no significant correlations between CIMT and various factors, attributing this to limitations in the CIMT measurement methodology used. The authors highlight the importance of understanding and addressing these limitations when using CIMT as a surrogate marker for preclinical atherosclerosis. The study's findings and conclusions regarding CIMT data should be interpreted with caution due to the identified methodological flaws. [Extracted from the article]

The article in the European Heart Journal discusses the impact of genetic variants on atherosclerosis by integrating bulk and single-cell transcriptomics. The study focuses on the Aryl Hydrocarbon Receptor Nuclear Translocator Like gene (ARNTL) and its role in modulating vascular smooth muscle cell (VSMC) phenotype and proliferation. The research highlights the importance of understanding the genetic and cellular mechanisms underlying atherosclerosis to improve risk stratification and potentially develop targeted therapies. The study emphasizes the need for further research to confirm the causal relationship between genetic variants, such as ARNTL, and atherosclerosis. [Extracted from the article]

Abstract Background Diabetic kidney disease (DKD) is associated with a higher risk of cardiovascular disease (CVD). Pentoxifylline (PTF), a nonselective phosphodiesterase inhibitor with anti-inflammatory, antiproliferative, and antifibrotic actions, has demonstrated renal benefits in both clinical trials and meta-analyses. The present work aimed to study the effects of PTF on the progression of subclinical atherosclerosis (SA) in a population of patients with diabetes and moderate to severe chronic kidney disease (CKD). Methods In this open-label, randomized controlled, prospective single-center pilot study the evolution of carotid intima-media thickness (CIMT) and ankle-brachial index (ABI) were determined in 102 patients with type 2 diabetes mellitus and CKD assigned to PTF, aspirin or control groups during 18 months. We also determined the variations in the levels of inflammatory markers and Klotho (KL), a protein involved in maintaining cardiovascular health, and their relationship with the progression of SA. Results Patients treated with PTF presented a better evolution of CIMT, increased KL mRNA levels in peripheral blood cells (PBCs) and reduced the inflammatory state. The progression of CIMT values was inversely related to variations in KL both in serum and mRNA expression levels in PBCs. Multiple regression analysis demonstrated that PTF treatment and variations in mRNA KL expression in PBCs, together with changes in HDL, were significant determinants for the progression of CIMT (adjusted R2 = 0.24, P

Purpose Data regarding the association between metabolically healthy obesity (MHO) and preclinical atherosclerosis in childhood are lacking. Carotid intima-media thickness (cIMT) is a noninvasive method used to assess cardiovascular risk. This study examined the relationships among cIMT, metabolic phenotypes, and cardiometabolic risk factors (CMRFs) in overweight and obese adolescents. Methods Anthropometric, biochemical, and cIMT data were collected. The study participants were categorized as MHO or metabolically unhealthy obesity (MUO) based on insulin resistance. CMRFs were assessed using blood pressure (BP); levels of triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting plasma glucose; or a diagnosis of diabetes mellitus. Differences in cIMT values were evaluated according to the metabolic phenotype and factors associated with cIMT. Results Among the 111 participants (80 boys, 72.1%), 23 (20.7%) were classified as MHO and 88 (79.3%) as MUO. The MHO group exhibited lower glycated hemoglobin and triglyceride levels and higher HDL-C levels compared to those exhibited by the MUO group (all P

Abstract Elevated levels of the gut pro-hormone Proneurotensin (proNT) have been found to predict development of cardiovascular disease. However, it is still unknown whether higher proNT levels are associated with subclinical vascular damage. Herein, we investigated the relationship between higher proNT concentrations and augmented pulse pressure (PP) and carotid intima-media thickness (cIMT), indicators of increased arterial stiffness and subclinical atherosclerosis, respectively. Clinical characteristics, PP and cIMT were evaluated in 154 non-diabetic individuals stratified into tertiles according to fasting serum proNT concentrations. We found that, subjects with higher proNT levels exhibited a worse lipid profile and insulin sensitivity, increased C-reactive protein levels, along with higher values of PP and cIMT as compared to the lowest proNT tertile. Prevalence of elevated PP (≥ 60 mmHg) and subclinical carotid atherosclerosis (IMT > 0.9 mm) was increased in the highest tertile of proNT. In a logistic regression analysis adjusted for several confounders, subjects with higher proNT levels displayed a fivefold raised risk of having elevated PP values (OR 5.36; 95%CI 1.04–27.28; P = 0.05) and early carotid atherosclerosis (OR 4.81; 95%CI 1.39–16.57; P = 0.01) as compared to the lowest proNT tertile. In conclusion, higher circulating levels of proNT are a biomarker of subclinical vascular damage independent of other atherosclerotic risk factors.

Background: Hashimoto thyroiditis (HT) is associated with myocardial dysfunction, it is attributed to the autoimmune chronic inflammation and other endocrine factors. Aim of the work: Detection of subclinical myocardial dysfunction in children with euthyroid Hashimoto thyroiditis using speckle tracking echocardiography and estimation of carotid intima- media thickness. Patients and Methods: We performed a case-control cross-sectional study that involved 15 children with euthyroid HT following up at the Endocrinology Clinic, Ain Shams University Children’s Hospital from October 2020 to July 2021 and 15 healthy controls of comparable age and sex. Both groups underwent conventional and speckle tracking echocardiography in addition to estimation of carotid intima-media thickness by high resolution ultrasound machine. Results: The children with euthyroid HT had a mean ± SD age of 13.20 ± 3.05 years, while that of the control group was 11.80 ± 3.03 years (p=0.21). Twelve (80%) of the children with HT and 11(73%) of the control group were females (p=0.66). The mean ± SD for serum-free T3, free T4 and thyroid stimulating hormone (TSH) were 3.57 ± 1.07, 1.43 ± 0.76 ng/dl, and 4.03 ± 2.27 IU/ml in patients, and were 3.59±9.21 pg/ml, 1.29±0.15 ng/dl and 3.4 ±0.3 IU/ml in control group (p = 0.474), (p=0.249) and (p=0.316) respectively. The mean (range) left ventricular global longitudinal strain of the cases and control group were within the normal range (-20.44± 1.24) (- 23 to -17.4) and (-20.94± 0.59) (-21.8 to -19.5) respectively) (p= 0.159). The mean carotid intima- media thickness was normal in both cases (0.35 ±0.05 cm) and controls (0.33 ±0.05 cm) (p = 0.47). Conclusion: Euthyroid state seems to protect against subclinical myocardial dysfunction in Hashimoto thyroiditis.

Objectives: To evaluate the intima-media thickness (IMT) and elasticity of the carotid artery in non-obese polycystic ovary syndrome (PCOS) patients using a quantitative technique for vascular elasticity measurement and to explore the influencing factors. Methods: Sixty non-obese patients without metabolic and cardiovascular diseases who were diagnosed with PCOS in the Women and Children's Hospital of Chongqing Medical University from January to December 2022 were prospectively selected (case group), and 60 healthy volunteers matched for body mass index were included as the control group. Body weight, height, heart rate, blood pressure, and waist-to-hip ratio were recorded. Fasting blood samples were drawn from the elbow vein to measure hormone levels including total testosterone (TT), sex hormone-binding globulin (SHBG), fasting plasma glucose (FPG), fasting insulin (FINS), lipids, and homocysteine (Hcy). The insulin resistance index (HOMA-IR) and free androgen index (FAI) were calculated. Ultrasound elastography was used to measure the IMT and elastic function parameters of the right carotid artery, including vessel diameter, wall displacement, stiffness coefficient, and pulse wave velocity. Differences in various parameters between the two groups were analyzed, and correlations between the carotid stiffness coefficient and other serological indicators were assessed using Spearman correlation analysis. Results: No significant differences in age, body mass index, heart rate, systolic blood pressure, and diastolic blood pressure were observed between the two groups (all P>0.05), while the waist-to-hip ratio (WHR) was higher in the case group than in the control group (P<0.05).The hormone level serological indicators TT and FAI were higher in the case group than in the control group, and SHBG was lower in the case group than in the control group (all P<0.05). The metabolism-related serum indicators LDL-C, HDL-C, FPG, triglycerides, and total cholesterol levels were not statistically different between the two groups (all P>0.05), and serum FINS, HOMA-IR, and Hcy levels were significantly higher in the case group than in the control group (all P<0.05).No significant difference in carotid artery diameter was observed between the case group and control group (P>0.05). The carotid artery displacement in the case group was significantly smaller than that in the control group (P<0.05), and carotid IMT, hardness coefficient, and pulse wave propagation velocity were greater in the case group than in the control group (all P<0.05). The carotid elastic stiffness coefficient was positively correlated with WHR, TT, SHBG, FAI, FINS, HOMA-IR and Hcy to varying extents and negatively correlated with SHBG. Conclusion: In non-obese PCOS patients with no metabolic or cardiovascular disease, the carotid stiffness coefficient was increased and correlated with indicators of hyperandrogenism, insulin resistance, and hyperhomocysteinemia. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases remain a leading global cause of mortality worldwide especially in older adults. Although it is known that regular exercise reduces cardiovascular diseases incidence, its effects on specific cardiovascular aging parameters considering the influence of sex and different exercise designs are still not fully understood. Therefore, this systematic review and meta-analysis aims to evaluate the effects of different physical exercise protocols on age-related cardiovascular outcomes in older adults. Methods: This systematic review and meta-analysis will be reported in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles will be eligible if they are randomized controlled trials with a primary objective of evaluating the chronic effects of exercise interventions on cardiovascular aging parameters. Search strategy will be performed from the inception to September 30th, 2023, in the following electronic databases: MEDLINE (Ovid), SCOPUS (Elsevier), Embase, Sport Discus (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science Core Collection (Clarivate Analytics). Data will be extracted and managed through Research Electronic Data Capture (REDCap) software. The Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX) will be used to assess the methodological quality of included studies. Additionally, the quality of the findings will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) profiler. Meta-analysis based on the random-effects model will be performed (if deemed suitable, considering the methodological and clinical heterogeneity of the studies) to estimate the effects of exercise training on cardiovascular aging variables (i.e., cardiac output; arterial stiffness; stroke volume; endothelial function; and carotid intima-media thickness). Heterogeneity will be assessed with the I2 statistics, while the publication bias will be assessed based on Egger's test. Discussion: To the best of our knowledge, this will be the first systematic review and meta-analysis to investigate the impact of sex and training protocols on the cardiovascular aging parameters. Moreover, the findings of this systematic review and meta-analysis will provide evidence for health professionals in the management of elderly patients in order to optimize the exercise prescription to face the cardiovascular alterations related to the aging process, considering the effects of different protocols according to sex. Systematic review registration: PROSPERO CRD42023441015. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with increased cardiovascular disease (CVD) risk and mortality. This work aimed to evaluate the serum levels of the novel CV biomarkers fetuin-A (fet-A), Dickkopf-1 (DKK-1), galectin-3 (Gal-3), interleukin-32 (IL-32), and catestatin (CST) in RA patients and their associations with RA parameters and CVD markers. A cohort of 199 RA patients was assessed for traditional CVD risk factors, RA disease activity, and biomarker levels. Carotid ultrasound was used to measure carotid intima-media thickness (cIMT) and carotid plaque presence (cPP). Multivariate analyses examined correlations between biomarkers and RA parameters, serological markers, and CVD markers. Adjusted models showed that elevated CST expression levels were associated with rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) positivity (OR = 2.45, p = 0.0001 and OR = 1.48, p = 0.04, respectively) in the overall cohort and for RF in men and women, respectively. In addition, fet-A concentration was inversely associated with the erythrocyte sedimentation rate (ESR) in the overall cohort (β = −0.15, p = 0.038) and in women (β = −0.25, p = 0.004). Fet-A levels were also negatively correlated with disease activity (DAS28-ESR) scores (β = −0.29, p = 0.01) and fibrinogen concentration (β = −0.22, p = 0.01) in women. No adjusted associations were observed for Gal-3, DKK-1 or IL32 concentration. The study revealed no significant associations between the biomarkers and cIMT or cPP. The measurement of CST and fet-A levels could enhance RA patient management and prognosis. However, the utility of biomarkers for evaluating CV risk via traditional surrogate markers is limited, highlighting the need for continued investigations into their roles in RA. [ABSTRACT FROM AUTHOR]

Background/Objectives: Numerous risk factors associated with development of cardiovascular disease (CVD) have been unfavorably altered in patients with chronic kidney disease (CKD). Low omega-3 polyunsaturated fatty acid (PUFA) intake and vitamin D deficiency are potential cardiometabolic risk factors in patients with CKD. The aim of this study was to evaluate dietary intake and status of omega-3 PUFA and vitamin D in pre-dialysis and hemodialysis patients and to examine the association of dietary α-linolenic acid (ALA) and fish consumption with blood pressure and carotid intima–media thickness (C-IMT), representing a non-invasive marker of atherosclerosis in CKD patients. Methods: All 77 selected patients (36 pre-dialysis, 41 on hemodialysis) underwent standardized clinical, nutritional, and laboratory assessments. Repeated 24 h recalls were performed to assess dietary intake. The fatty acid profile was determined by gas–liquid chromatography. Results: Inadequate vitamin D intake and vitamin D status were found in 95% of patients. PUFA profiles did not differ between hemodialysis and pre-dialysis participants. Dietary intake of ALA was negatively correlated with systolic blood pressure (SBP) (p = 0.013), C-IMT (p = 0.002), serum CRP (p = 0.044), iPTH (p = 0.01), and 25(OH)D3 (p = 0.006). ALA intake of more than 0.23 g daily was linked with lower SBP (p = 0.001), serum 25(OH)D3 (p = 0.004), and C-IMT (p = 0.002). Conclusions: This study contributes to a better understanding of the relationship between dietary ALA intake and C-IMT in CKD. The results of this study could emphasize the significant role of the high prevalence of vitamin D deficiency and inadequate omega-3 PUFA intake and status regarding CVD health in CKD patients. [ABSTRACT FROM AUTHOR]

Investigate the impact of remnant cholesterol (RC) levels on carotid artery intima thickness (CIT) in type 2 diabetes mellitus (T2DM) patients. From September 2021 to September 2023, a prospective multicenter study involved 158 T2DM patients. They were divided into a higher RC group (n = 80) and a lower RC group (n = 78) based on median RC levels. Additionally, 92 healthy volunteers served as the control group. CIT, carotid media thickness (CMT), and carotid intima-media thickness (CIMT) were measured. General clinical data, lab results, CIMT, CIT, and CMT differences among the three groups were compared. Multiple regression analysis explored CIT factors in T2DM patients. 1. No significant sex, age, BMI, high-density lipoprotein cholesterol (HDL-C), T2DM duration, fasting blood glucose, or glycated hemoglobin differences were found among the groups (p > 0.05). 2. CIMT and CIT were significantly higher in T2DM than the control group (p < 0.05). 3. The higher RC group had thicker CIT than the lower RC group (p < 0.05), while CIMT differences were not significant (p > 0.05). Multiple linear regression analysis showed RC as an influencing CIT factor in T2DM patients (β = 0.473, p = 0.005). CIT is significantly thicker in T2DM patients with higher RC than in those with lower RC, and RC is the influence factor of CIT, which suggests that more attention should be paid to the detection of RC in T2DM patients. [ABSTRACT FROM AUTHOR]

Objective Patients with Behçet's disease (BD) may experience long-term morbidity caused by various forms of cardiovascular disease. This study aimed to assess the risk for cardiovascular comorbidity in paediatric BD patients with and without vascular involvement, independent of the contribution of traditional risk factors. Methods Paediatric patients classified as having BD according to the 2015 Peadiatric BD (PEDBD) criteria were included in the study. Twenty-four-hour ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography, and carotid intima-media thickness (cIMT) measurements were performed. Patients with an active disease or those who have other known risk factors for cardiovascular disease were not included in the study. Results Thirty-one children and adolescents with paediatric BD (16 female, 51.6%; F/M: 1.06) were enrolled in the study. Among the BD patients, 10 patients (34.4%) had abnormal ABPM. Carotid IMT values, mean arterial pressure, systolic and diastolic blood pressure by ABPM and the prevalence of abnormal ABPM, non-dipping, and ambulatory hypertension were similar between patients with and without vascular involvement. The echocardiography measurements showed that BD patients with vascular involvement had a significantly higher velocity and velocity time integral of the left ventricle outflow tract, which may indicate increased stiffness of the aorta. Conclusion Paediatric BD patients with vascular involvement may tend to have more cardiovascular risk factors. However, cardiovascular assessment should be considered in all BD patients, regardless of the involved systems. We suggest that ABPM may accurately define hypertension and cardiovascular risk in BD. [ABSTRACT FROM AUTHOR]

Carotid intima-media thickness (cIMT), a marker of subclinical atherosclerosis, has been found to be associated with incident stroke. High-sensitivity C-reactive protein (CRP) and fibrinogen have been demonstrated to be associated with atherosclerosis. Previous studies on heritability estimates of IMT, CRP, and fibrinogen among Chinese populations are limited. This study aims to estimate the heritability of these risk factors in residents who participated in the Taichung Community Health Study (TCHS) and their family members. A total of 2671 study subjects from 805 families were enrolled in the study, selected from a random sample of TCHS participants and their family members. CRP, and fibrinogen were obtained from each participant, and a questionnaire interview was conducted. cIMT was measured by high-resolution B-mode ultrasound and expressed as the mean of the maximum. Heritability estimates and the familial correlation of cIMT, CRP, and fibrinogen among family pairs were determined with SAGE software. With multivariate adjustments, significant heritability was found for cIMT (h2 = 0.26, P < 0.001), CRP (h2 = 0.34, P < 0.001), and fibrinogen (h2 = 0.48, P < 0.001). The intrafamilial correlation coefficients for the three indexes in the parent–offspring pairs were significant (P < 0.001) and ranged from 0.17 to 0.41. The full sibship correlations were also significant (P < 0.001) for the three indexes and ranged from 0.19 to 0.47. This study indicates that a moderate proportion of the variability in CRP, fibrinogen, and cIMT can be attributed to genetic factors in Chinese populations. The findings suggest that CRP is associated with cIMT, whereas no significant association exists between fibrinogen and cIMT. [ABSTRACT FROM AUTHOR]

Background: Obesity in polycystic ovary syndrome (PCOS) may increase the risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is an acceptable marker in assessing the risk of heart disease. Objective: This study aimed to evaluate the CIMT in PCOS women compared to non-PCOS women. Materials and Methods: This cross-sectional study was conducted on 48 women who referred to Imam Reza hospital, Kermanshah, Iran from July 2020-2021. Women were divided into 2 groups of PCOS and non-PCOS women (n = 24/each). The intima-media thickness of participants' carotid artery was measured on both sides in 3 areas, and its mean was recorded. Results: The mean thickness of the carotid artery intima-media in the case group was within the normal range; but it was significantly higher than the control group (0.71 ± 0.17 vs. 0.57 ± 0.09 mm, p = 0.019). Conclusion: Considering the higher thickness of CIMT in women with PCOS, it can be concluded that PCOS increases the risk of heart diseases in women. [ABSTRACT FROM AUTHOR]

Inflammation plays a crucial role in the development of atherosclerotic plaques. Pentraxin 3 (PTX3) is produced at the site of inflammation and has been identified as a specific marker of atherosclerosis, vascular inflammation, and progression of the coronary artery disease (CAD). The aim of the study was to establish if PTX3 has potential relations with classical markers of cardiovascular risk, and if PTX3 may act as an independent risk factor of CAD occurrence and advancement. The study included 98 patients with stable CAD confirmed in coronary angiography (CAD group) (median age 65 interquartile range [IQR] 61–72 years; 72 ​% men). The control group consisted of 40 patients without CAD. The CAD group had significantly higher PTX3 concentration compared to the control group. There was a correlation with age, male gender, lipid profile and intima-media thickness. There was no correlation between PTX3 concentration and the number of coronary vessels with significant atherosclerotic lesions and the advancement of atherosclerotic lesions on the Gensini scoring scale. The cut-off point was determined for 0.89 ​ng/ml for the exclusion of angiographically significant atherosclerotic lesions. Patients with CAD have significantly higher concentration of PTX3. There was no correlation between PTX3 and the advancement of angiographically significant atherosclerotic lesions in coronary arteries. Low PTX3 concentration may serve as an indicator for the absence of atherosclerosis. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide, and atherosclerosis is the key factor promoting its development. Carotid intima-media thickening and the presence of carotid plaques are important indices of cardiovascular risk. In addition, inflammation is a major and complex factor in the development of atherosclerosis. The relationships between carotid atherosclerosis and certain inflammatory markers have rarely been studied in healthy individuals. Therefore, we aimed to investigate the associations between subclinical carotid atherosclerosis and various inflammatory biomarkers in a large Caucasian population free of evident CVD. In addition to recording study participants' demographic characteristics, anthropometric characteristics, and atherosclerotic risk factors, laboratory tests were performed to measure levels of hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein, and inflammatory cytokines/chemokines, including interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, IL-33, interferon (IFN)-α2, IFN-γ, tumor necrosis factor-α, and monocyte chemoattractant protein (MCP)-1. This study included 264 asymptomatic individuals with a median age of 61.7 years (interquartile range, 54.5–67.5 years); 45.7% of participants were male. Participants were divided into two groups according to their carotid status: the normal carotid group, comprising 120 participants; and the pathological carotid group, comprising 144 participants. Compared with the normal carotid group, hypertension and diabetes mellitus were significantly more common and serum levels of HbA1c, IL-8, and MCP-1 were significantly higher in the pathological carotid group. Multivariate regression analysis revealed significant positive associations between pathological carotid findings and serum levels of IL-8 (highest tertile, OR: 2.4, p = 0.030) and MCP-1 (highest tertile, OR: 2.4, p = 0.040). Our results suggest that IL-8 and MCP-1 may serve as early indicators of subclinical atherosclerosis, thereby helping to identify individuals at increased risk of CVD before the onset of clinical symptoms. [ABSTRACT FROM AUTHOR]

Cognitive decline seems to be largely influenced by the patient's cardiovascular status, which automatically requires an early identification of cardiovascular risk factors, as well as indicators of cardiovascular function degradation, in order to protect cognitive status as early as possible. Although it is not entirely clear how risk factors for vascular disease may also be risk factors for cognitive decline, a link between reduced cerebral blood flow and reduced functional output and neuronal population is intuited. We tried to see if there are correlations between the ultrasonographic parameters of the wall of the carotid vascular axis and cognitive decline reveld by psychometric tests, such as MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment), The results of our study provide additional evidence regarding a link between the ultrasonographic parameters of the carotid artery wall and the cognitive decline assessed both with the application of the MMSE test and the MOCA test. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The carotid stiffness is an important factor in the pathogenesis of cerebrovascular small vessel disease. Our study aimed to evaluate the relation of the local arterial stiffness of the common carotid artery (CCA) to the hemodynamic forces and blood viscosity in patients with cerebral lacunar infarctions (LI). METHODS: Twenty-two patients with chronic LI and 15 age-matched controls were examined. An ultrasound examination of the CCA intima-media thickness (IMT), the parameters of local CCA stiffness: distensibility (DC) and compliance coefficients (CC), α and β stiffness indices and pulse wave velocity (PWV) was performed. The local hemodynamic forces were calculated: circumferential wall tension (CWT) and wall shear stress (WSS). Whole blood viscosity (WBV) and shear stresses at shear rates of 0.277 s- 1 to 94.5 s- 1 were measured in patients and controls. RESULTS: Higher values of IMT, a significant decrease of DC and CC and an increase of α and β stiffness indices and PWV in the LI patients compared to the controls were obtained. A parallel significant increase in CWT and a decrease in WSS was found. An increase in WBV and a significant increase in shear stresses were detected. In the LI patients, the increased stiffness indices were associated with an increase in age, cholesterol and WBV at higher shear rates in the left CCA. In the controls, the IMT and stiffness indices correlated significantly with the hemodynamic factors and WBV in both CCAs, while the stiffness indices correlated with the hemodynamic forces in the left CCA. CONCLUSION: The results of the present study demonstrate different associations of the local carotid stiffness indices with the hemodynamic forces and WBV in patients with LI and controls. [ABSTRACT FROM AUTHOR]

Background: the relationship between vitamin D deficiency and carotid intima-media thickness (CIMT) in children and adolescents with obesity is unknown. The aim of this study was to investigate the correlation between vitamin D levels and CIMT in children and adolescents with obesity. Methods: a total of 440 children and adolescents aged 6-16 with obesity were included in the study. Anthropometric measurements, blood pressure measurements, blood lipids, blood glucose, and vitamin D levels were measured. Bilateral carotid ultrasound was performed to assess CIMT. The relationships between vitamin D levels and CIMT were assessed using multivariate linear regression with Generalized Linear Models and restricted cubic splines. Binary logistic regression analyses were conducted to explore the association between vitamin D status and the risk of abnormal CIMT. Results: vitamin D levels were inversely correlated with CIMT in subjects with serum 25-hydroxyvitamin D [25(OH)D] levels less than or equal to 50 nmol/L (ß = -0.147, 95 % CI [-0.263, -0.030], p = 0.013), but this correlation was not significant in subjects with serum 25(OH)D levels above 50 nmol/L. After correcting for various confounders, the risk of abnormal CIMT was significantly higher in the vitamin D deficiency group (OR = 2.080, 95 % CI [1.112, 3.891], p = 0.022). Conclusions: vitamin D deficiency is an independent risk factor for abnormal CIMT, and vitamin D deficiency may play a promoting role in the atherosclerotic process in children and adolescents with obesity. [ABSTRACT FROM AUTHOR]

Carotid atherosclerosis disease assessment can predict the patient's risk of cardiovascular disease (CVD). The purpose of this review is to provide a comprehensive review of carotid atherosclerosis disease's pathophysiology, diagnostic evaluation, imaging applications, and treatment strategies. Carotid atherosclerosis is diagnosed using a variety of techniques, including transcranial Doppler imaging (TCD), computed tomography angiography (CTA), magnetic resonance angiography (MRA), and cerebral digital subtraction angiography (DSA), with duplex ultrasound (DUS) as the primary screening. Measurements of carotid intima- media thickness (CIMT) have drawn attention recently as a marker of early-stage carotid atherosclerosis or CVD risk prediction. The classification of cardiovascular risk may be enhanced by the expanding fields of stress testing and carotid plaque screening. [ABSTRACT FROM AUTHOR]

Introduction: In the Netherlands, the prevalence of cardiovascular diseases (CVDs) is higher among South-Asian Surinamese and lower among Moroccans compared to the Dutch. Traditional risk factors for atherosclerotic CVD do not fully explain these disparities. We aimed to assess ethnic differences in plaque presence and carotid intima-media thickness (cIMT) and explore to what extent these differences are explained by traditional risk factors. Methods: We used cross-sectional data from a subgroup of participants enrolled in the multi-ethnic population-based Healthy Life in an Urban Setting (HELIUS) study who underwent carotid ultrasonography. Logistic and linear regression models were built to assess ethnic differences in plaque presence and cIMT with the Dutch population as reference. Additional models were created to adjust for socioeconomic status, body height, and cardiovascular risk factors. Results: Of the 3,022 participants, 1,183, 1,051, and 790 individuals were of Dutch, South-Asian Surinamese, and Moroccan descent, respectively. Mean age was 60.9 years (SD: 8.0), and 52.8% were female. Compared to the Dutch, we found lower odds for plaque presence in Moroccans (0.77, 95% CI: 0.62; 0.95) and no significant differences between the South-Asian Surinamese and Dutch population (0.91, 95% CI: 0.76; 1.10). After adjustment for CVD risk factors, we found a lower plaque presence in South-Asian Surinamese (0.63, 95% CI: 0.48; 0.82). In both Moroccan and South-Asian Surinamese individuals, adjustment for socioeconomic status did not materially change the results. cIMT was lower in South-Asian Surinamese compared to the Dutch (−17.9 μm, 95% CI: −27.9; −7.9) and partly explained by ethnic differences in the body height as South-Asian Surinamese individuals were, on average, shorter than the Dutch population. No differences in cIMT between Moroccans and Dutch were found. Conclusions: cIMT and plaque prevalence differ between ethnic groups independent of CVD risk. Lower plaque prevalence in Moroccans was partly attributable to a lower prevalence of traditional CVD risk factors, while body height was an important contributor to differences in cIMT in South Asians. This study emphasizes the need for ethnic-specific cut-off values for plaque presence and cIMT. [ABSTRACT FROM AUTHOR]

Objective: To analyze the association between the peripheral blood lymphocyte subsets and the occurrence of carotid atherosclerosis (CAS) and discuss the risk factors of CAS, and to provide the basis for risk prediction and early intervention of CAS. Methods: A total of 419 subjects were selected according to the inclusion and exclusion criteria. All the subjects underwent carotid ultrasonography, and the detection of T lymphocyte, B lymphocyte, and natural killer (NK) cell subsets were performed. According to the carotid artery intima-media thickness (IMT), the subjects were divided into normal carotid artery group (n=166) and CAS group (n=253). The basic data and laboratory inspection indexes of the subjects n two groups were collected, including age, gender, blood pressure, medical history, smoking history, medication history, blood lipids, and percentages of T lymphocyte, B lymphocyte, and NK cell subsets. The risk factors for the occurrence of CAS of the subjects were analyzed using Logistic regression analysis. Results: The univariate analysis results showed that compared with normal carotid artery group, the age, morbidity rate of hypertension, morbidity rate of diabetes, and smoking rate of the subjects in CAS group were increased (P<0. 05), and the percentages of CD4+ T lymphocytes, CD4+ T lymphocyte count, CD4+/CD8+ ratio, CD16+CD56+NK cell count, and low-density lipoprotein cholesterol (LDL-c) level in peripheral blood were increased (P<0. 05), while the percentage of CD8+T lymphocyte was decreased (P<0. 05). The multivariable Logistic regression analysis results showed that age (OR= 1. 112, 95%CI: 1. 083-1. 142, P<0. 001), smoking (OR=1. 997, 95%CI: 1. 192-3. 346, P=0. 009), LDL-c (OR=1. 427, 95%CI: 1. 017-2. 001, P=0. 039), and percentage of CD4+T lymphocyte (OR=1. 044, 95%CI: 1. 002-1. 087, P=0. 039) were the independent risk factors for the occurrence of CAS. Conclusion: The percentage of CD4+ T lymphocyte is associated with the occurrence of CAS and it is a predictive risk factor for CAS. [ABSTRACT FROM AUTHOR]

Aging affects the cardiovascular system, and this process may be accelerated in individuals with cardiovascular risk factors. The main vascular changes include arterial wall thickening, calcification, and stiffening, together with aortic dilatation and elongation. With aging, we can observe left ventricular hypertrophy with myocardial fibrosis and left atrial dilatation. These changes may lead to heart failure and atrial fibrillation. Using multimodality imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging, it is possible to detect these changes. Additionally, multimodality imaging, mainly via CT measurements of coronary artery calcium or ultrasound carotid intima-media thickness, enables advanced cardiovascular risk stratification and helps in decision-making about preventive strategies. The focus of this manuscript is to briefly review cardiovascular changes that occur with aging, as well as to describe how multimodality imaging may be used for the assessment of these changes and risk stratification of asymptomatic individuals. [ABSTRACT FROM AUTHOR]

Background: Diabetes contributes to a spectrum of complications encompassing microvascular and macrovascular disorders. This study aimed to explore the correlation between distal sensorimotor polyneuropathy (DSPN) severity and heightened carotid atherosclerosis among individuals with type 2 diabetes mellitus (T2DM). Method: Participants underwent comprehensive assessments including nerve conduction studies (NCS), Toronto Clinical Neuropathy Score (TCNS) evaluations, assessment of cardiometabolic risk factors, and carotid sonography studies covering dynamic and morphological parameters. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) in both the common carotid artery (CCA) and internal carotid artery (ICA), carotid intima-media thickness (IMT), and carotid plaque score (CPS) were also measured. Peripheral nerve function severity was assessed using composite amplitude scores (CAS) derived from NCS. Results: Individuals with DSPN exhibited lower EDV in the CCA and ICA (p < 0.0001 and p = 0.002), higher PI and RI in both CCA and ICA (all p < 0.0001), and higher CPS (p = 0.002). They also demonstrated a higher prevalence of retinopathy as an underlying condition, higher index HbA1c, and reduced estimated glomerular filtration rate (eGFR) (all p < 0.0001). Multiple linear regression analysis revealed significant associations where eGFR, ICA-PI, index HbA1c, waist circumference, and age were correlated with CAS. Meanwhile, diabetes duration, waist circumference, age, and index HbA1c showed significant associations with TCNS. Conclusions: Our study suggests that individuals with T2DM who exhibit more severe carotid atherosclerosis may not only be at increased risk of developing DSPN but also may experience greater severity of DSPN. PI in both the CCA and ICA, along with the CPS, serve as surrogate biomarkers for DSPN severity. [ABSTRACT FROM AUTHOR]

Introduction: Hypercholesterolemia is a risk factor for premature arteriosclerosis. Inflammation and oxidative stress are thought to contribute to endothelial dysfunction preceding vasculopathy. We investigated the association between inflammation, glycocalyx biomarkers, endothelial function, and vascular parameters in children with hypercholesterolemia. Methods: In 22 patients (LDL-cholesterol >130 mg/dL; median age [IQR]: 13 [2.3] years) and 22 controls (13 [2.5] years), tumor necrosis factor-alpha (TNF-α), oxidized cholesterol (oxLDL), and glycocalyx biomarkers (Syndecan-1, Hyaluronan) were measured using immunoassays. Endothelial function was assessed by peripheral arterial tonometry, sublingual glycocalyx and microcirculation by videomicroscopy and carotid intima-media thickness by ultrasound. Results: OxLDL was significantly higher in patients (78.9 [38.2] vs. 50.3 [16.6] U/L, p = 0.002), whereas all other experimental parameters were comparable between groups. Multivariate analysis revealed a significant association of Syndecan-1 with TNF-α (β = 0.75, p < 0.001) and with hypercholesterolemia (β = 0.31, p = 0.030). The interaction term combining TNF-α and hypercholesterolemia showed a significant effect (p = 0.034). Sex was an independent predictor of endothelial function. Conclusion: The combined effect of hypercholesterolemia and inflammation on glycocalyx perturbation and the impact of sex in the premature development of arteriosclerosis deserve further evaluation. Therapeutic approaches tackling low-grade systemic inflammation may offer potential to prevent or delay progression of cardiovascular disease and cardiovascular complications. [ABSTRACT FROM AUTHOR]

Chronic pain is associated with development of cardiovascular disease. We investigated the association between how widespread chronic pain is and the development of cardiovascular dysfunction. We analysed data from participants enrolled in the UK Biobank study who underwent examinations at baseline, plus first follow-up and two imaging visits. Pain sites (including hip, knee, back, neck/shoulder, or 'all over the body') and pain duration were recorded at each visit. Chronic pain was defined as pain lasting for ≥3 months. Participants were categorised into six groups: no chronic pain, chronic pain in one, two, three, or four sites, or 'all over the body'. Arterial stiffness index was measured at each time point. Carotid intima-media thickness, cardiac index, and left ventricular ejection fraction (LVEF) were measured using ultrasound and heart MRI at two additional imaging visits in a subset of participants. Mixed-effect linear regression models were used for the analyses. The number of chronic pain sites was directly related to increased arterial stiffness index (n =159,360; β=0.06 per one site increase, 95% confidence interval 0.04 to 0.08). In 23,899 participants, lower LVEF was associated with widespread chronic pain (β=–0.17 per one site increase, 95% confidence interval –0.27 to –0.07). The number of chronic pain sites was not associated with carotid intima-media thickness (n =30,628) or cardiac index (n =23,899). A greater number of chronic pain sites is associated with increased arterial stiffness and poorer cardiac function, suggesting that widespread chronic pain is an important contributor to cardiovascular dysfunction. [ABSTRACT FROM AUTHOR]

Objective: To evaluate accuracy and feasibility of a handheld ultrasound machine for measuring carotid artery intima-media thicknesses (CIMT) and hemodynamic parameters by different expertise levels of ultrasound operators. Methods: : The operators were divided into three groups based on the level of their medical expertise: ultrasound technician, sonographer, and nursing staff. Operators from each group measured the CIMT and hemodynamic parameters of 25 volunteers using both handheld ultrasound and a conventional ultrasound machine. The reliability and reproducibility of handheld ultrasound measurements of CIMT and hemodynamic parameters (peak systolic velocity (PSV), end-diastolic velocity (EDV)) in operators were analyzed. Results: After a period of training, there was no statistically significant difference between the mean CIMT measured using handheld ultrasound among the three operators (0.45 ± 0.09 mm, 0.50 ± 0.07 mm, 0.46 ± 0.08 mm, P > 0.05, respectively), as well as PSV (83.30 ± 15.42 cm/s, 76.28 ± 13.26 cm/s, 81.12 ± 21.21 cm/s, P > 0.05, respectively) and EDV (21.04 ± 4.12 cm/s, 21.87 ± 5.05 cm/s, 20.17 ± 5.90 cm/s, respectively, P > 0.05). Furthermore, there was a good repeatability and consistent of handheld ultrasound device in measuring mean CIMT in the ultrasound technician and sonographer groups (r = 0.662, 0.691, respectively, P < 0.01). Conclusions: Under the premise of proper training, handheld ultrasound systems are feasible for rapid and primary assessment of carotid artery by operators with different levels of expertise. [ABSTRACT FROM AUTHOR]