Data density curves of B-mode ultrasound arterial wall thickness measurements in unaffected control and at-risk populations.
OBJECTIVE
Atherosclerosis is a slow disease process of arterial walls with onset decades prior to its clinical manifestations. Lifelong follow-up data may help to identify and understand the pathophysiology of this process. These longitudinal data are scarce. Using a standardized imaging and image analysis protocol, we acquired cross-sectional data of carotid and femoral arterial wall segments in populations at different cardiovascular disease risk.


METHODS
B-mode ultrasound intima-media thickness (IMT) data of carotid and femoral arteries were acquired in individuals at high cardiovascular disease risk: 44 young adolescents with familial hypercholesterolemia (FH), 248 adult FH patients and 184 patients with coronary artery disease (CAD), as well as in disease free unaffected individuals, 44 young adolescents, 26 middle-aged adults and 48 senior adults.


RESULTS
Per patient combined average IMT (SD) and % of lesions in the high risk populations were 0.55 (0.05) mm, 0.1%, 0.86 (0.18) mm, 15%, and 0.9 (0.18) mm, 18%, respectively. In the unaffected groups these values were 0.53 (0.03) mm, 0%, 0.59 (0.07) mm, 0%, and 0.77 (0.12) mm, 8%. Of all arterial segments, the far wall of the common femoral artery (CFA) of the FH patients exhibited the highest absolute IMT (1.12 [0.61] mm), the most rapid estimated IMT increase since adolescence (+0.58 mm) and the highest percentage of lesions (39% of CFA measurements).


CONCLUSIONS
Regardless of location, carotid and femoral arterial walls increase in thickness with age and cardiovascular disease risk. This increase in thickness and prevalence of lesions is not similarly distributed among anatomical segments. The strong preponderance in arterial wall segments with the highest estimated atherosclerosis progression indicates the existence of a threshold value beyond which plaque formation is greatly increased. In the set of arterial locations we studied, this process might be best represented by the far wall of the CFA.
De Groot
E
E
Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands. ericdegroot@amc.uva.nl
Hovingh
G K
GK
Zwinderman
A H
AH
Wiegman
A
A
Smit
A J
AJ
Kastelein
J J P
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000000981:diagnostic imaging; D014463:Ultrasonography