title: Thicknesses of individual layers of artery wall indicate increased cardiovascular risk in severe pre-eclampsia.
abstract: OBJECTIVE
  To assess whether thicknesses of the intima and media in the common carotid artery (CCA) and the intima/media ratio (I/M) indicate an increased cardiovascular risk in non-pregnant women with a history of previous severe pre-eclampsia.
  
  
  METHODS
  Thicknesses of the CCA intima and media layers were measured using non-invasive high-frequency (22 MHz) ultrasound in 42 women with a history of severe pre-eclampsia and 44 women with previous normal pregnancy.
  
  
  RESULTS
  Women with a history of severe pre-eclampsia had a thicker CCA intima and a higher I/M than had women with previous normal pregnancy, also after adjustment for mean arterial pressure, body mass index and CCA intima-media thickness (IMT) (all P < 0.0001). CCA-IMT did not differ significantly between groups. In receiver-operating characteristics curve analysis, intima thickness and I/M clearly discriminated between women with and those without previous pre-eclampsia (area under the receiver-operating characteristics curve (AUC), 0.98 and 0.93), whereas CCA-IMT did not (AUC, 0.52).
  
  
  CONCLUSIONS
  CCA individual intima and media thicknesses as well as I/M, but not CCA-IMT, reflect the known increased long-term cardiovascular risk of pre-eclampsia. Estimation of individual CCA layers using high-frequency ultrasound appears preferable to measuring CCA-IMT for investigating arterial effects and the increased cardiovascular risk in women with a history of severe pre-eclampsia.
authors.affiliation: Department of Women's and Children's Health, Section for Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Akhter
authors.forename: M
authors.initials: M
authors.lastname: Larsson
authors.forename: A K
authors.initials: AK
authors.lastname: Wikström
authors.forename: T
authors.initials: T
authors.lastname: Naessen
mesh_terms: D000328:Adult; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000473:pathology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000473:pathology*; D012372:ROC Curve; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
keywords: cardiovascular disease; high-frequency ultrasound; intima thickness; intima/media ratio; media thickness; pre-eclampsia