Engelhorn Carlos Alberto, Engelhorn Ana Luiza, Cassou Maria Fernanda, Zanoni Cassiana Casagrande, Gosalan Carlos José, Ribas Emerson, Pacholok Adriana, Koehler Marcela de Fátima
Pontifícia Universidade Católica do Paraná e Angiolab, Curitiba, PR, Brazil.
Arq Bras Cardiol. 2006 Nov;87(5):609-14. doi: 10.1590/s0066-782x2006001800010.
OBJECTIVE: Common carotid artery intima-media thickness (IMT) is considered a factor of cardiovascular risk and an early marker of coronary artery disease. This study aimed to investigate the existence of a correlation between IMT in the carotid arteries and at the origin of the right subclavian artery, as well as to evaluate IMT in the subclavian artery as an earlier marker of cardiovascular risk. METHODS: One hundred and six consecutive patients, 52 males and 54 females, average age 51 years, underwent color Doppler ultrasonography to evaluate carotid and right subclavian arteries. The relationship between carotid IMT and right subclavian IMT was assessed using the Pearson's correlation coefficient analysis and a 95% confidence interval. Reliability of right subclavian artery IMT measurement for the diagnosis of early thickening (considering a > 0.8 mm carotid thickness as reference) was described as to sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Cut-off values for the right subclavian IMT were indicated by the ROC curve, and p values < or = 0.05 were considered statistically significant. RESULTS: Out of the 41 patients whose carotid arteries were IMT-free, 30 (73%) had right subclavian artery IMT values > 0.8 mm. The mean IMT value for the carotid artery was 0.87 mm (SD = 0.23) and for the subclavian artery, 1.17 mm (SD = 0.46), with a 0.31 correlation coefficient (95% CI: 0.12; 0.47). The ROC curve analysis indicated a cut-off value of 0.7 mm for the right subclavian artery IMT, using as reference a 0.8 mm cut-off value for the carotid artery (91% sensitivity, 27% specificity, 66% PPV, 65% NPV, and 66% accuracy). CONCLUSION: Our study showed that carotid artery IMT correlates well with right subclavian artery IMT. With a 0.7 mm cut-off value, it is possible to detect IMT in the right subclavian artery earlier than in the carotid arteries. The IMT at the origin of the right subclavian artery can be considered an earlier marker for the assessment of cardiovascular risk.
目的：颈总动脉内膜中层厚度（IMT）被视为心血管风险因素及冠状动脉疾病的早期标志物。本研究旨在调查颈动脉与右锁骨下动脉起始处IMT之间是否存在相关性，并评估锁骨下动脉IMT作为心血管风险早期标志物的情况。 方法：106例连续患者，男性52例，女性54例，平均年龄51岁，接受彩色多普勒超声检查以评估颈动脉和右锁骨下动脉。使用Pearson相关系数分析和95%置信区间评估颈动脉IMT与右锁骨下动脉IMT之间的关系。描述右锁骨下动脉IMT测量对早期增厚诊断（以颈动脉厚度>0.8mm为参考）的可靠性，包括敏感性、特异性、阳性预测值、阴性预测值和准确性。通过ROC曲线确定右锁骨下动脉IMT的截断值，p值≤0.05被认为具有统计学意义。 结果：在41例颈动脉无IMT的患者中，30例（73%）右锁骨下动脉IMT值>0.8mm。颈动脉的平均IMT值为0.87mm（标准差=0.23），锁骨下动脉为1.17mm（标准差=0.46），相关系数为0.31（95%CI：0.12；0.47）。ROC曲线分析表明，以颈动脉截断值0.8mm为参考，右锁骨下动脉IMT的截断值为0.7mm（敏感性91%，特异性27%，阳性预测值66%，阴性预测值65%，准确性66%）。 结论：我们的研究表明颈动脉IMT与右锁骨下动脉IMT相关性良好。截断值为0.7mm时，可在右锁骨下动脉比颈动脉更早检测到IMT。右锁骨下动脉起始处的IMT可被视为评估心血管风险的早期标志物。
Int J Cardiol. 2006-4-14
Int J Cardiovasc Imaging. 2016-5
Zotero 插件