Rheumatology Department, Instituto Médico Platense, La Plata, Argentina.
Clinica Reumatologica, Università Politecnica delle Marche, Jesi, Italy.
Rheumatology (Oxford). 2021 Nov 3;60(11):5362-5368. doi: 10.1093/rheumatology/keab117.
To measure with US the intima-media thickness (IMT) of temporal (superficial, parietal and frontal branches) and axillary arteries in subjects without a diagnosis of GCA and/or PMR with different cardiovascular (CV) risk; and to assess the performance of previously proposed cut-off values for normal IMT.
Subjects ≥ 50 years without a diagnosis of GCA or PMR were included. Bilateral US of the temporal arteries, including the frontal and parietal branches, and axillary arteries was performed by two sonographers using a 10-22 MHz and 6-18 MHz probe. The following previously proposed cut-offs were considered: superficial temporal artery: 0.42 mm; frontal branch: 0.34 mm; parietal branch: 0.29 mm; axillary artery: 1.0 mm.
A total of 808 arteries in 101 subjects were evaluated; of these, 31 (30.7%) were classified as very high CV risk, seven (6.9%) as high, 34 (33.7%) as moderate and 29 (28.7%) as low risk. Subjects with very high or high risk showed higher IMT than those with moderate or low risk in the superficial temporal arteries [0.23 (s.d. 0.07) vs 0.20 (s.d. 0.04), P < 0.01] and in the axillary arteries [0.54 (s.d. 0.17) vs 0.48 (s.d. 0.10), P = 0.002] . The IMT was higher than the reference cut-off in 13/808 (1.6%) arteries, in ≥1 artery in 10/101 subjects (10.1%). Of these 10 subjects, 8 (80%) were classified as having very high or high risk.
Our results suggest that CV risk might influence the US-determined IMT of the temporal and axillary arteries in subjects without GCA. Therefore, in patients with suspected GCA, particular attention should be paid when measuring the IMT in those patients with very high/high CV risk.
使用超声测量无巨细胞动脉炎（GCA）和/或多发性肌炎（PMR）诊断的、不同心血管（CV）风险人群颞动脉（浅、顶和额支）和腋动脉的内-中膜厚度（IMT）；并评估先前提出的正常 IMT 截断值的性能。
纳入≥50 岁、无 GCA 或 PMR 诊断的受试者。由两名超声医师使用 10-22MHz 和 6-18MHz 探头对颞动脉（包括额支和顶支）和腋动脉进行双侧超声检查。考虑了以下先前提出的截断值：颞浅动脉：0.42mm；额支：0.34mm；顶支：0.29mm；腋动脉：1.0mm。
共评估了 101 名受试者的 808 支动脉；其中，31 支（30.7%）被归类为极高 CV 风险，7 支（6.9%）为高风险，34 支（33.7%）为中风险，29 支（28.7%）为低风险。极高或高风险组的受试者与中或低风险组相比，在颞浅动脉[0.23（s.d.0.07）vs 0.20（s.d.0.04），P<0.01]和腋动脉[0.54（s.d.0.17）vs 0.48（s.d.0.10），P=0.002]中的 IMT 更高。在 808 支动脉中，有 13 支（1.6%）的 IMT 高于参考截断值，在 101 名受试者中，有 10 名（10.1%）至少有一支动脉的 IMT 高于参考截断值。这 10 名受试者中，有 8 名（80%）被归类为极高或高风险。
我们的结果表明，CV 风险可能会影响无 GCA 受试者颞动脉和腋动脉的 US 测量 IMT。因此，在怀疑 GCA 的患者中，当测量那些极高/高 CV 风险患者的 IMT 时，应特别注意。
