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Thicker carotid intima layer and thinner media layer in subjects with cardiovascular diseases: An investigation using noninvasive high-frequency ultrasound
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
2006 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 189, no 2, 393-400 p.Article in journal (Refereed) Published
Abstract [en]

Background: The thickness of the arterial intima increases and that of the media decreases with increasing age and degree of atherosclerosis. Separate estimates of the individual intima and media layers might therefore be more appropriate than the commonly used method estimating the combined intima-media thickness (IMT).

Methods and results: One hundred consecutive 70-year-old subjects from the PIVUS study were investigated. Separate estimates of the thickness of the carotid artery intima and media wall layers were carried out noninvasively using 25 MHz high-frequency ultrasound. Subjects with a diagnosis of cardiovascular disease (CVD), coronary heart disease (CHD), myocardial infarction (MI) or stroke had a significantly thicker intima layer (all P < 0.0001) and a thinner media layer (all P < 0.05) than healthy subjects. The intima/media thickness ratio also differed significantly between subjects with and without a diagnosis of CVD (0.43 +/- 0.20 versus 0.75 +/- 0.48, P = 0.0002). Subjects with hypertension or hyperlipidemia also had a thicker carotid intima than subjects without these diagnoses (P < 0.0005 for both). None of the corresponding intima + media thickness values differed significantly. Similar results were obtained in women and men.

Conclusion: Separate assessment of carotid artery intima and media thickness using noninvasive high-frequency ultrasound appears to be of potential value. as a striking difference in intima thickness and the intima/media thickness ratio was found between subjects with and without CVD.

Place, publisher, year, edition, pages
2006. Vol. 189, no 2, 393-400 p.
Keyword [en]
carotid artery wall, intima-media thickness (IMT), cardiovascular disease, atherosclerosis, high-frequency ultrasound
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-92786DOI: 10.1016/j.atherosclerosis.2006.02.020ISI: 000242305800020PubMedID: 16530771OAI: oai:DiVA.org:uu-92786DiVA: diva2:166080
Available from: 2005-04-07 Created: 2005-04-07 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Artery Wall Imaging and Effects of Postmenopausal Estrogen Therapy
Open this publication in new window or tab >>Artery Wall Imaging and Effects of Postmenopausal Estrogen Therapy
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Postmenopausal estrogen therapy, initiated early in the menopause, seems to protect against development of atherosclerosis and cardiovascular diseases. This thesis concerns studies of artery wall thickness and arterial stiffness estimated by noninvasive ultrasound techniques in long-term estrogen treated postmenopausal women who initiated therapy at the time of the menopause.

A noninvasive 25 MHz high-frequency ultrasound technique was validated in the imaging of superficial arteries by using an animal model. Ultrasound estimates of the artery wall layers obtained in vivo in the pig were compared to ex-vivo histomorphometry. Valid estimates of total artery wall and media thickness were found for the most superficial arteries. Adventitia thickness was underestimated and intima thickness overestimated in this animal model when non-atherosclerotic vessels were imaged.

To validate the clinical usefulness of separately estimating the artery wall layers in the human, the carotid artery wall was imaged in elderly subjects. Separate estimates of intima thickness, media thickness and intima/media ratio differed significantly between subjects with and without atherosclerosis and CVD, indicating that this noninvasive high-frequency ultrasound method might be a strong tool in monitoring changes in artery wall morphology associated with aging and development of atherosclerosis.

The investigation of intima thickness, media thickness and intima/media ratio of the carotid and femoral arteries in long-term estrogen treated postmenopausal women showed a maintenance of a thin intima and a preservation of media thickness and intima/media ratio at values similar to those obtained in women of fertile age. By comparing estrogen-users with age-matched postmenopausal nonusers, long-term estrogen therapy initiated at the time of the menopause seemed to counteract the increase in intima and decrease in media thickness associated with aging and development of atherosclerosis. The preservation of the artery wall morphology into older age might be a mechanism for the well-documented cardioprotective effects of estrogen when therapy is initiated early after menopause. However, long-term estrogen therapy showed no substantial effects on the age-related changes in arterial stiffness estimated at the aorta, carotid and femoral arteries, suggesting that any long-term cardioprotective effect that estrogen therapy may have is unlikely to be mediated by an impact on arterial stiffness.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2005. 51 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 23
Keyword
Medicine, artery wall thickness, tunica media, tunica intima, arterial stiffness, carotid, aorta, cardiovascular disease, atherosclerosis, menopause, estrogen, hormone therapy, ultrasound, Medicin
National Category
Dermatology and Venereal Diseases
Identifiers
urn:nbn:se:uu:diva-5722 (URN)91-554-6193-X (ISBN)
Public defence
2005-04-28, Rosénsalen, Kvinnokliniken, Akademiska Sjukhuset ing 95-96, Uppsala, 13:15
Opponent
Supervisors
Available from: 2005-04-07 Created: 2005-04-07Bibliographically approved

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