Singh Shaanemeet, Nagra Aslam, Maheshwari Puneet, Panwar Rajababu, Hecht Harvey, Fukumoto Takenori, Bansal Manish, Panthagani David, Lammertin Georgeanne, Kasliwal Ravi, Mishra Hemant, Hofstra Leonard, Singh Mahendra Pratap, Fuster Valentin, Sengupta Partho P, Narula Jagat
Shah Satnamji Specialty Hospital, Sirsa, India.
Mahatma Gandhi Medical College and Hospital, Jaipur, India.
Glob Heart. 2013 Jun;8(2):83-9. doi: 10.1016/j.gheart.2013.05.001.
Cardiovascular disease (CVD)-related death rates have been escalating in emerging economies such as India. A strategy to initiate prophylactic medical intervention by direct identification of subclinical atherosclerotic burden may be appropriate in rural populations where assessment based on traditional risk factors is not available.
This study sought to investigate the feasibility of performing rapid automated carotid ultrasound studies in a rural setting and to measure the prevalence of carotid plaques and age-specific distribution of carotid intima-media thickness (IMT) as an index of subclinical atherosclerosis.
Screening of the extracranial carotid system with automated B-mode ultrasound was performed along with health questionnaire assessments in 771 asymptomatic volunteers (ages 40 ± 14 years; 626 men and 145 women) with no known CVD. Measurements of IMT were recorded as the mean of 24 spatial measurements performed over a 1-cm region in the far wall of the common carotid artery at end diastole; the prevalence of the plaque (focal IMT >1.5 mm) was determined.
A total of 69 (8.9%) subjects had atherosclerotic plaques. Of these, 16 (2.1%) exhibited bilateral plaques, 28 (3.6%) left carotid plaque only, and 25 (3.2%) had right carotid plaques. Patients even under 50 years showed a high prevalence of carotid plaques (7%), which increased with age (25% and 35% for 51 to 70 and >70 years, respectively). Only 3 (4.3%) participants with plaques were former smokers. Global mean IMT was 0.55 ± 0.13 mm and correlated with age for both left and right carotid arteries (r = 0.61 and 0.60, p < 0.001 for both) in male as well as female subjects (r = 0.70 and 0.67, p < 0.001 for both), respectively.
Rapid community screening for subclinical atherosclerosis is feasible with automated carotid ultrasound examination and may be beneficial in rural communities of industrializing nations where traditional CVD risk factor data are not yet readily available.
在印度等新兴经济体中，心血管疾病（CVD）相关死亡率一直在上升。对于无法根据传统危险因素进行评估的农村人口，通过直接识别亚临床动脉粥样硬化负担来启动预防性医疗干预的策略可能是合适的。
本研究旨在调查在农村地区进行快速自动颈动脉超声检查的可行性，并测量颈动脉斑块的患病率以及作为亚临床动脉粥样硬化指标的颈动脉内膜中层厚度（IMT）的年龄特异性分布。
对771名无已知CVD的无症状志愿者（年龄40±14岁；男性626名，女性145名）进行自动B型超声对颅外颈动脉系统的筛查，并进行健康问卷评估。IMT测量记录为舒张末期在颈总动脉远壁1厘米区域内进行的24次空间测量的平均值；确定斑块的患病率（局灶性IMT>1.5毫米）。
共有69名（8.9%）受试者有动脉粥样硬化斑块。其中，16名（2.1%）表现为双侧斑块，28名（3.6%）仅左侧颈动脉有斑块，25名（3.2%）右侧颈动脉有斑块。甚至50岁以下的患者颈动脉斑块患病率也很高（7%），且随年龄增加而上升（51至70岁和>70岁的患者分别为25%和35%）。只有3名（4.3%）有斑块的参与者曾经吸烟。全球平均IMT为0.55±0.13毫米，在男性和女性受试者中，左右颈动脉的IMT均与年龄相关（男性r = 0.61和0.60，两者p < 0.001；女性r = 0.70和0.67，两者p < 0.001）。
通过自动颈动脉超声检查对亚临床动脉粥样硬化进行快速社区筛查是可行的，这可能对工业化国家农村社区有益，因为在这些社区传统的CVD危险因素数据尚不可得。
