title: Prediction of carotid plaques in hypertensive patients by risk factors, left ventricular hypertrophy, and epicardial adipose tissue thickness.
abstract: Hypertension and other risk factors (RFs) predispose to carotid plaques (CPs). An association between left ventricular hypertrophy (LVH) or epicardial adipose tissue (EAT) and CPs has also been reported. The aim of the study was to evaluate whether the assessment of LVH and EAT thickness, beyond RFs, would be of additive value in predicting CPs in hypertensive subjects. We studied 548 hypertensive patients aged ≥ 50 years without carotid bruit. LVH and CPs were evaluated and defined according to standard criteria. EAT was measured by echocardiography above the free wall of the right ventricle at end diastole. The presence of LVH and EAT thickness above the median value (3.9 mm) together significantly increased prevalence of CPs in subjects with 0-1 risk factor, but not in those with ≥ 2 RFs who showed high prevalence of CPs independently of LVH and/or EAT. Receiver operating characteristic curve analysis showed that the addition of LVH and higher EAT thickness together significantly improved prediction of CPs in patients with 0-1 risk factor. Indeed, the area under the curve improved from 0.63 (0.56-0.69) to 0.73 (0.67-0.79), which was significantly higher (p < 0.05). In patients with ≥ 2 RFs, the addition of LVH and EAT did not significantly improve prediction of CPs. This study shows that the presence of LVH and higher EAT thickness together improves prediction of CPs in hypertensive patients with 0-1 risk factor and that those with ≥ 2 RFs show high prevalence of CPs independently of LVH and/or EAT.
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università Gabriele d'Annunzio, Patologia Medica, Policlinico Santissima Annunziata, Via dei Vestini, 66013, Chieti Scalo (Chieti), Italy. pierdomenico@unich.it
authors.forename: Sante D
authors.initials: SD
authors.lastname: Pierdomenico
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Mancini
authors.forename: Chiara
authors.initials: C
authors.lastname: Cuccurullo
authors.forename: Maria D
authors.initials: MD
authors.lastname: Guglielmi
authors.forename: Anna M
authors.initials: AM
authors.lastname: Pierdomenico
authors.forename: Marta
authors.initials: M
authors.lastname: Di Nicola
authors.forename: Silvio
authors.initials: S
authors.lastname: Di Carlo
authors.forename: Domenico
authors.initials: D
authors.lastname: Lapenna
authors.forename: Franco
authors.initials: F
authors.lastname: Cuccurullo
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity; D000368:Aged; D019540:Area Under Curve; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010496:Pericardium / Q000000981:diagnostic imaging*; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed