Article

Increased echolucency of carotid plaques in patients with type 2 diabetes.

Clinical Research Unit, Malmö University Hospital, Malmö, Sweden.
Stroke (Impact Factor: 6.16). 08/2007; 38(7):2074-8. DOI: 10.1161/STROKEAHA.106.480830
Source: PubMed

ABSTRACT Diabetes is associated with the presence of moderate to large atherosclerotic carotid plaques. Previous carotid ultrasound studies have associated plaques with low echogenicity with a higher risk of cerebrovascular events. The aim of this study was to evaluate whether patients with type 2 diabetes have different plaque echogenicity than do nondiabetic subjects.
Forty-seven type 2 diabetic and 51 nondiabetic subjects with a carotid plaque in the right artery were included in this study. All patients were born in 1935 to 1936 and were participants in a population-based study. Carotid ultrasonography was performed and the risk factors for cardiovascular disease were determined. Plaque echogenicity was assessed quantitatively on B-mode ultrasound images by standardized gray-scale median values.
Gray-scale median values were significantly lower, indicating more echolucent plaques, in patients with type 2 diabetes compared with nondiabetics (37.0+/-14.8 vs 45.5+/-15.4, P=0.007). Of the other risk factors studied, only triglycerides were significantly associated with the echogenicity of the plaque.
Patients with type 2 diabetes have more echolucent plaques compared with nondiabetic subjects. This might be associated with the higher risk of cardiovascular events among diabetics.

0 Bookmarks
 · 
67 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Increased carotid intima-media thickness (IMT) has been associated with increased risk of myocardial infarction (MI) and stroke. A measure of echogenicity, the grey scale median (GSM), has been shown to be inversely correlated with cardiovascular risk factors and to be predictive of mortality in a community-based cohort. We assessed the factors associated with carotid IM-GSM in younger, non-diabetic patients with a recent MI. A total of 122 patients (women, 25%) aged 31-80 years (61) were recruited 2-3 days after an acute MI. Ultrasound examinations of the carotid arteries were performed 1-12 months after the MI. IMT was 0·78 (SD 0·17) mm on the right side and 0·81 (0·20) mm on the left side (P = 0·05). GSM was 88·60 (range 46-132, SD 18·32) on the right side and 82·10 (40-126, 17·89) on the left side (P = 0·002). Triglycerides (TG) correlated with GSM on both sides (right, r = -0·27, P = 0·003; left, r = -0·18, P = 0·05). On the right side, GSM was 92·15 and 82·26 (P = 0·05) in patients with TG < and ≥1·7, and on the left side, it was 84·04 and 74·55 (P = 0·02) in patients with TG < and ≥2·3. On multivariate analysis, TG were significantly associated with GSM, both on the right side (P = 0·01) and on the left side (P = 0·009). We found a negative association between TG and carotid IM-GSM on both sides in patients with a recent MI. Our results also suggest that atherosclerosis progression may be faster on the left side in patients with coronary heart disease.
    Clinical Physiology and Functional Imaging 09/2012; 32(5):400-3. · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Grey scale median (GSM) measured on ultrasound images of carotid plaques has been used for several years now in research to find the vulnerable plaque. Centres have used different software and also different methods for GSM measurement. This has resulted in a wide range of GSM values and cut-off values for the detection of the vulnerable plaque. The aim of this study was to compare the values obtained with two different softwares, using different standardization methods, for the measurement of GSM on ultrasound images of carotid human plaques. GSM was measured with Adobe Photoshop(®) and with Artery Measurement System (AMS) on duplex ultrasound images of 100 consecutive medium- to large-sized carotid plaques of the Beta-blocker Cholesterol-lowering Asymptomatic Plaque Study (BCAPS). The mean values of GSM were 35·2 ± 19·3 and 55·8 ± 22·5 for Adobe Photoshop(®) and AMS, respectively. Mean difference was 20·45 (95% CI: 19·17-21·73). Although the absolute values of GSM differed, the agreement between the two measurements was good, correlation coefficient 0·95. A chi-square test revealed a kappa value of 0·68 when studying quartiles of GSM. The intra-observer variability was 1·9% for AMS and 2·5% for Adobe Photoshop. The difference between softwares and standardization methods must be taken into consideration when comparing studies. To avoid these problems, researcher should come to a consensus regarding software and standardization method for GSM measurement on ultrasound images of plaque in the arteries.
    Clinical Physiology and Functional Imaging 05/2013; · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. Numerous reports have shown the relationship between carotid artery atherosclerosis and coronary artery disease (CAD). However, the association between complex CAD evaluated by SYNTAX score (SxScore) and prevalence of carotid lesion has not been fully investigated. We sought to assess the prevalence of carotid atherosclerosis in patients with multivessel CAD assessed by SxScore and the relationship between SxScore severity and features of carotid atherosclerosis. Methods and results. Subjects were 204 consecutive patients with multivessel CAD assessed by coronary angiography and no previous history of carotid atherosclerosis that underwent carotid ultrasound scan (US) from June 2012 to June 2013. Presence of carotid lesion (CL), significant carotid disease (SCD) and carotid plaque morphology was evaluated. At least one CL was found in 159 patients (77.9 %) with no significant difference among SxScore groups (p=0.20 and p=0.54, respectively). High prevalence of complex carotid plaque (CCP) was found without significant different distribution in SxScore groups (p=0.69). Age was independently associated with the presence of CL (odds ratio [OR] 1.055; 95% confidence interval [CI]: 1.015-1.097; p=0.007) and SCD (OR 1.057; 95% CI: 1.008-1.097; p=0.019). Age and diabetes were independently associated with CCP (OR 1.58; 95% CI: 1.023-1.095; p=0.001; OR 1.848; 95% CI: 1.026-3.327; p=0.041). SxScore was not independently associated with carotid lesion, SCD and CCP (all p>0.2). Conclusions. We found high prevalence of CL in patients with multivessel complex CAD. However SxScore does not seem to correlate with carotid atherosclerosis. © 2013 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 12/2013; · 2.51 Impact Factor

Full-text (2 Sources)

View
19 Downloads
Available from
May 28, 2014